副神经化上斜方肌肌皮瓣即刻修复舌鳞癌缺损的初步探索

发布时间：2018-02-13 19:25

本文关键词： 舌肿瘤癌鳞状细胞斜方肌肌皮瓣功能重建神经吻合　出处：《重庆医学》2017年35期 　论文类型：期刊论文

【摘要】：目的探讨副神经化上斜方肌肌皮瓣即刻修复舌鳞癌手术后舌体缺损的临床疗效。方法收集2015年1月至2016年12月重庆医科大学附属口腔医院口腔颌面外科收治的6例经病理确诊的舌鳞癌患者,均行舌颈联合根治性颈清术,术中采用副神经和舌下神经吻合术的上斜方肌肌皮瓣同期修复舌缺损。供区创面直接拉拢缝合,未行植皮。结果 6例皮瓣全部成活。6个月至1年后,皮瓣呈现黏膜化,类似口腔黏膜形态,质地良好。再造舌的早期(3个月内)动度主要依靠残留舌体的运动。6个月后再造舌有明显动度,但灵活度较健侧差,患者对语言、吞咽等功能满意。结论副神经化上斜方肌肌皮瓣是修复舌鳞癌术后缺损理想皮瓣之一。
[Abstract]:Objective to investigate the clinical effect of immediate repair of tongue body defect with superior trapezius musculocutaneous flap from January 2015 to December 2016. Methods from January 2015 to December 2016, 6 cases of oral and maxillofacial surgery, affiliated Hospital of Chongqing Medical University, were collected. A case of tongue squamous cell carcinoma confirmed by pathology, All patients were treated with tongue neck combined with radical cervical debridement. The superior trapezius myocutaneous flap of accessory nerve and hypoglossal nerve anastomosis was used to repair tongue defect simultaneously. The donor wound was closed and sutured directly. No skin graft was performed. Results all the 6 flaps survived. After 6 months to 1 year, the flaps showed mucosal degeneration, similar to oral mucosal morphology. The early (within 3 months) motility of the reconstructed tongue mainly depended on the movement of the residual body of the tongue. After 6 months, the reconstructed tongue had obvious motility, but the flexibility was lower than that of the healthy side. Conclusion the superior trapezius myocutaneous flap is one of the ideal flaps for repairing the defects of tongue squamous cell carcinoma.
【作者单位】：重庆医科大学附属口腔医院口腔颌面外科;口腔疾病与生物医学重庆市重点实验室;重庆市高校市级口腔生物医学工程重点实验室;
【基金】：重庆市医学科研计划[2015ZDXM019,2016(社)07]
【分类号】：R739.86

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