耳后瓣联合多瓣修复颞部恶性肿瘤大缺损一例

发布时间：2018-10-15 18:11

【摘要】：目的总结1例应用耳后瓣联合多瓣修复右颞部恶性肿瘤组织大缺损的效果。方法 2016年1月收治1例右颞部肿物男性患者,75岁;肿物大小约为4 cm×4 cm。术中病理示鳞状细胞癌。术中行扩大切除术、面神经解剖术,肿物切除后组织缺损范围为8 cm×8 cm。于缺损部邻近组织设计制备耳后瓣、鼻唇沟瓣、颊瓣、颈胸皮瓣,大小分别约为4 cm×3 cm、4 cm×2 cm、4 cm×3 cm、8 cm×4 cm,联合修复创面。结果术后皮瓣血运良好,均成活,供受区创面均Ⅰ期愈合。术后1个月内因皮瓣张力过大,右口角向上偏移;外眦受牵拉外移,致右眼裂变小。术后3个月随访,右侧口角位置基本恢复正常,眼周稍肿胀,眼裂稍小,皮瓣色泽、质地均良好。术后4个月面部外形对称,表情自然协调正常,患者满意。结论耳后瓣联合多瓣修复颞部组织大缺损效果良好,手术方法较简便,尤其适合老年患者。
[Abstract]:Objective to summarize the effect of posterior ear flap combined with multiple flaps in repairing large defect of right temporal malignant tumor. Methods A 75-year-old male patient with right temporal mass was treated in January 2016. The tumor size was about 4 cm 脳 4 cm.. Intraoperative pathology showed squamous cell carcinoma. The area of tissue defect was 8 cm 脳 8 cm. after extensive excision, dissection of facial nerve and resection of tumor. The posterior ear flap, nasolabial flap, buccal flap and cervicothoracic flap were designed in the adjacent tissues of the defect. The size of the flap was about 4 cm 脳 3 cm,4 cm 脳 2 cm,4 cm 脳 3 cm,8 cm 脳 4 cm, respectively. Results the skin flap had good blood circulation and survived, and all the donor wounds were healed in the first stage. The tension of the flap was too large and the angle of the right mouth shifted upward within one month after operation, and the lateral canthus was pulled out and the right eye fission was small. After 3 months follow-up, the position of the right mouth angle returned to normal, the eye was slightly swollen, the fissure of the eye was slightly small, the color and texture of the flap were all good. At 4 months after operation, the facial appearance was symmetrical, the facial expression was naturally coordinated and normal, and the patient was satisfied. Conclusion posterior auricular flap combined with multiple flaps is effective in repairing large temporal defect, and the operative method is relatively simple, especially suitable for elderly patients.
【作者单位】：中南大学湘雅医学院附属海口医院口腔医学中心颌面外科·海南省口腔医学中心;
【基金】：海南省卫生厅项目(琼卫2012PT-52) 海南省自然科学基金资助项目(813263)
【分类号】：R739.8

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