目的：比较颏下岛状皮瓣与游离前臂皮瓣修复口腔鳞癌术后缺损的结果。方法：2009年5月~2011年8月,69例口腔鳞癌术后缺损采用颏下岛状皮瓣或游离前臂皮瓣修复,比较2种修复方法的皮瓣大小、手术时间、住院时间、并发症、口腔功能恢复及复...目的：比较颏下岛状皮瓣与游离前臂皮瓣修复口腔鳞癌术后缺损的结果。方法：2009年5月~2011年8月,69例口腔鳞癌术后缺损采用颏下岛状皮瓣或游离前臂皮瓣修复,比较2种修复方法的皮瓣大小、手术时间、住院时间、并发症、口腔功能恢复及复发情况。结果：69例患者中,采用颏下岛状皮瓣修复32例,游离前臂皮瓣修复37例。颏下岛状皮瓣组与游离前臂皮瓣组在平均皮瓣大小（32.78cm2 VS 48.27cm2）、平均手术时间（351min VS 508min）、平均住院日（13.06dVS 17.48d）等均有统计学差异（P〈0.001）;两组患者总的并发症发生相似,但颏下岛状皮瓣组发生颌下区积液的比例较高（P〈0.05）;两组患者在术后口腔功能恢复及肿瘤复发方面无差异。结论：颏下岛状皮瓣修复可明显缩短手术时间及患者住院时间,可作为口腔鳞癌术后中小型缺损修复的首选。展开更多
Aim:Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained.We propose the use of the radi...Aim:Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained.We propose the use of the radial forearm free flaps(RFFF)as a superb method of re-establishing integrity in anterior skull base defects.Methods:Literature review and retrospective analysis of 4 single-institution cases of anterior skull base defects reconstructed with a RFFF.Data were collected on successful and unsuccessful defect repairs,complication rates,and length of hospitalization.Results:The indications for surgery were pneumocephalus,recurrent brain abscesses,recurrent frontal sinus mucoceles,and cerebrospinal fluid leak.Of the 4 cases,1 was complicated by a small dehiscence of the craniotomy site,1 developed infection,and 2 required further surgery.Conclusion:The use of RFFF is an excellent option for reconstruction of defects in the anterior skull base,especially those complicated by radiation,prior surgery,or infections.Patients with skull base defects are inherently at high risk for post-surgical complications.The RFFF transfers healthy,viable,well-vascularized tissue to prevent further infections and provides a reliable barrier between the dural and sinonasal spaces.This can reduce the need for repeat neurosurgical operations and hospitalizations.展开更多
文摘目的：比较颏下岛状皮瓣与游离前臂皮瓣修复口腔鳞癌术后缺损的结果。方法：2009年5月~2011年8月,69例口腔鳞癌术后缺损采用颏下岛状皮瓣或游离前臂皮瓣修复,比较2种修复方法的皮瓣大小、手术时间、住院时间、并发症、口腔功能恢复及复发情况。结果：69例患者中,采用颏下岛状皮瓣修复32例,游离前臂皮瓣修复37例。颏下岛状皮瓣组与游离前臂皮瓣组在平均皮瓣大小（32.78cm2 VS 48.27cm2）、平均手术时间（351min VS 508min）、平均住院日（13.06dVS 17.48d）等均有统计学差异（P〈0.001）;两组患者总的并发症发生相似,但颏下岛状皮瓣组发生颌下区积液的比例较高（P〈0.05）;两组患者在术后口腔功能恢复及肿瘤复发方面无差异。结论：颏下岛状皮瓣修复可明显缩短手术时间及患者住院时间,可作为口腔鳞癌术后中小型缺损修复的首选。
文摘Aim:Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained.We propose the use of the radial forearm free flaps(RFFF)as a superb method of re-establishing integrity in anterior skull base defects.Methods:Literature review and retrospective analysis of 4 single-institution cases of anterior skull base defects reconstructed with a RFFF.Data were collected on successful and unsuccessful defect repairs,complication rates,and length of hospitalization.Results:The indications for surgery were pneumocephalus,recurrent brain abscesses,recurrent frontal sinus mucoceles,and cerebrospinal fluid leak.Of the 4 cases,1 was complicated by a small dehiscence of the craniotomy site,1 developed infection,and 2 required further surgery.Conclusion:The use of RFFF is an excellent option for reconstruction of defects in the anterior skull base,especially those complicated by radiation,prior surgery,or infections.Patients with skull base defects are inherently at high risk for post-surgical complications.The RFFF transfers healthy,viable,well-vascularized tissue to prevent further infections and provides a reliable barrier between the dural and sinonasal spaces.This can reduce the need for repeat neurosurgical operations and hospitalizations.
