围裙式颈阔肌肌皮瓣在口腔颌面部缺损修复中的应用

发布时间：2018-10-05 09:31

【摘要】：目的:介绍一种新颖的颈阔肌肌皮瓣术式,评价其修复口腔颌面部缺损的应用价值。方法:用围裙式颈阔肌肌皮瓣修复口腔颌面部病变切除术后缺损的患者15例。设计U形的围裙式切口制备皮瓣,保留蒂部皮肤,加宽肌蒂宽度。结果:15例围裙式颈阔肌肌皮瓣12例完全成活,3例皮瓣部分坏死。其中,修复颊黏膜、舌、牙槽突缺损的皮瓣完全成活率分别为8/9、1/3、3/3。另有2例颈部供区伤口愈合不良。所有病例经4~33个月随访,1例牙龈癌颈部瘢痕较为明显,1例舌癌舌运动受限,其余病例口腔颌面部形态、功能恢复良好。结论:和颈阔肌肌皮瓣比较,围裙式颈阔肌肌皮瓣可提供更宽的皮岛,特别适合中小型颊部软组织及牙槽突缺损的修复,舌部缺损不是该皮瓣最佳适应证。
[Abstract]:Objective: to introduce a novel latissimus myocutaneous flap and evaluate its application value in repairing oral and maxillofacial defects. Methods: 15 cases of oral and maxillofacial defects were repaired with apron latissimus myocutaneous flap. A U-shaped apron incision was designed to prepare the flap, preserve the pedicle skin and widen the width of the muscle pedicle. Results 15 cases of apron latissimus myocutaneous flap were completely survived in 3 cases. Among them, the complete survival rate of the flaps repairing buccal mucosa, tongue and alveolar process defects was 8 / 9 / 3 / 3 / 3 / 3 respectively. There were also 2 cases of poor wound healing in the donor area of the neck. All the cases were followed up for 4 ~ 33 months. One case of cervical scar of gingival cancer was more obvious and 1 case of tongue cancer had limited tongue motility. The other cases had good shape and function recovery of oral and maxillofacial region. Conclusion: compared with latissimus cervicalis myocutaneous flap, apron latissimus myocutaneous flap can provide wider skin island, especially suitable for repairing soft tissue and alveolar process defect in middle and small buccal region. Tongue defect is not the best indication for this flap.
【作者单位】：中南大学湘雅一医院口腔医学中心;
【基金】：国家自然科学基金面上项目(编号:81041052,30572044)
【分类号】：R782.2

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