原发灶对侧颏下岛状肌皮瓣应用于口腔鳞状细胞癌术后组织缺损修复的可行性

发布时间：2018-03-02 10:49

本文关键词： 原发灶对侧颏下岛状肌皮瓣口腔鳞状细胞癌组织缺损修复可行性　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨原发灶对侧颏下岛状肌皮瓣应用于口腔鳞状细胞癌(oral squamous cell carcinomas OSCC)术后组织缺损修复的可行性,以期增加临床工作者的选择。方法:河北医科大学第四医院口腔科2013年11月-2016年1月之间收治的14例患者,12例患者为舌部肿物,2例患者为上牙龈肿物,术前经病理证实为鳞状细胞癌。年龄45-71岁。颌颈CT/MRI显示原发灶同侧有可疑转移淋巴结组织,而对侧没有。均采用原发灶对侧颏下岛状肌皮瓣修复术后组织缺损。通过随访观察,分析皮瓣的成活率、修复效果、术后并发症及肿瘤的复发和转移情况,判断原发灶对侧颏下岛状肌皮瓣的适应症,指导临床应用。结果:14例患者中出现皮瓣坏死现象0例,皮瓣成活率为100%。术后出现颈部血肿继而并发创腔感染1例。由面神经下颌缘支损伤产生的相应侧口角下垂症状0例;下唇外翻及猫耳畸形0例。随访时间失访1例,死亡1例。局部复发及颈部转移0例。结论:原发灶对侧颏下岛状肌皮瓣属于颏下岛状肌皮瓣的一种,是一种可靠的、切取相对简单的、修复效果较好的、成活率较高的且术后并发症少的皮瓣;能够用于原发灶同侧有可疑淋巴结转移患者;如果术前检查高度怀疑对侧有可疑淋巴结转移的患者,应慎用。
[Abstract]:Objective: to investigate the feasibility of using the contralateral submental island myocutaneous flap to repair the tissue defect after oral squamous cell carcinomas OSCC. Methods: from November 2013 to January 2016, 14 patients were admitted to the Department of Stomatology, 4th Hospital of Hebei Medical University. 12 patients with tongue tumor and 2 patients with upper gingival mass, were selected from the Department of Stomatology of 4th Hospital of Hebei Medical University from November 2013 to January 2016. Squamous cell carcinoma was proved by pathology before operation. The age was 45-71 years old. CT/MRI of maxillary neck showed suspected metastatic lymph node tissue on the ipsilateral side of the primary lesion, but not on the other side. All patients were treated with the primary contralateral submental island myocutaneous flap to repair the postoperative tissue defect. The survival rate, repair effect, postoperative complications and tumor recurrence and metastasis of the flap were analyzed, and the indications of the primary locus contralateral submental island myocutaneous flap were determined to guide clinical application. The survival rate of the flap was 100. There was 1 case of cervical hematoma and then complicated with wound cavity infection. There were 0 cases of drooping symptoms of the corresponding side of mouth angle caused by the injury of the mandibular marginal branch of the facial nerve, 0 cases of lower lip valgus and cat's ear malformation. One case died. Local recurrence and cervical metastasis were found in 0 cases. Conclusion: the primary contralateral submental island myocutaneous flap is a kind of submental island myocutaneous flap. The flap with high survival rate and less postoperative complications can be used in patients with ipsilateral suspected lymph node metastasis.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.8

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