本文選題：改良鼻唇溝皮瓣　切入點：前頰部　出處：《中國修復(fù)重建外科雜志》2015年05期

【摘要】：目的探討改良鼻唇溝皮瓣修復(fù)前頰部黏膜中小型缺損的療效。方法 2013年3月-2014年4月,收治10例前頰部黏膜病變患者。男8例,女2例;年齡39~62歲,平均47.2歲。左側(cè)4例,右側(cè)6例�？谇话装�3例,白斑惡變3例,口腔扁平苔蘚癌變1例,乳頭狀瘤3例。病程2~15個月,平均7.1個月。病變徹底切除后遺留黏膜和少量頰肌缺損,但未洞穿頰部。缺損寬2.5~4.0 cm、長3.5~5.5 cm,距離口角0.5~1.5 cm。設(shè)計蒂部位于口角旁、長軸沿鼻唇溝方向的彎月形改良鼻唇溝皮瓣,自表淺肌肉腱膜系統(tǒng)層面將上、下翼由末端向蒂部掀起,將皮瓣經(jīng)頰部隧道翻轉(zhuǎn)到達口內(nèi)用于修復(fù)黏膜缺損,口外供區(qū)切口直接拉攏縫合。結(jié)果術(shù)后鼻唇溝皮瓣均成活,創(chuàng)面Ⅰ期愈合;口外供區(qū)切口Ⅰ期愈合�；颊呔@隨訪,隨訪時間6~18個月,平均10.4個月�；颊卟∽儫o復(fù)發(fā),面型對稱滿意,術(shù)側(cè)面部器官無牽拉變形,線性瘢痕無明顯增生且隱藏于術(shù)側(cè)鼻唇溝內(nèi),未見面神經(jīng)損傷癥狀,口角形態(tài)正常�？诹褜挾容^術(shù)前無明顯縮小,末次隨訪時開口度2.7~3.5 cm,平均3.1 cm�？趦�(nèi)皮瓣菲薄平整,與周圍黏膜愈合良好,無明顯皮瓣攣縮、咬頰和閉口不全等現(xiàn)象發(fā)生。結(jié)論改良鼻唇溝皮瓣具有血供可靠、設(shè)計靈活、制備簡單、供區(qū)隱蔽等優(yōu)點,是修復(fù)前頰部黏膜中小型缺損的有效方法之一。
[Abstract]:Objective to evaluate the efficacy of modified nasolabial flap in repairing small and medium-sized defects of anterior buccal mucosa. Methods from March 2013 to April 2014, 10 patients with anterior buccal mucosal lesions (8 males and 2 females), aged 3962 years with an average of 47.2 years, and 4 patients with left buccal mucosal lesions were treated. There were 6 cases of right side, 3 cases of oral leukoplakia, 3 cases of leukoplakia, 1 case of carcinogenesis of oral lichen planus and 3 cases of papilloma. The course of disease ranged from 2 to 15 months (mean 7.1 months). The defect was 2.5 ~ 4.0 cm wide, 3.55 ~ 5.5 cm long, and 0.5 ~ 1.5 cm from the angle of mouth. The designed pedicle was located next to the mouth angle. The long axis of the modified nasolabial flap along the nasolabial groove direction would be up from the superficial muscle aponeurosis system, and the lower wing would be lifted from the end to the pedicle. The flap was turned over through the buccal tunnel to repair the mucosal defect, and the incision of the external donor area was closed and sutured directly. Results the nasolabial flap survived and the wound healed in the first stage, and the incision of the extraoral donor area healed in the first stage. All the patients were followed up. The follow-up time was 6 ~ 18 months (mean 10.4 months). The patients had no recurrence, symmetrical and satisfactory facial shape, no stretch deformation of the lateral organs, no obvious hyperplasia of linear scar and hidden in the nasolabial sulcus of the operative side, and no symptom of nerve injury. The width of oral fissure was not significantly reduced compared with that before operation. At the last follow-up, the opening degree was 2.7 ~ 3.5 cm, with an average of 3.1 cm. The intraoral flap was thin and smooth, healed well with the surrounding mucosa, and had no obvious flap contracture. Conclusion the modified nasolabial flap has the advantages of reliable blood supply, flexible design, simple preparation and hidden donor area, and is one of the effective methods for repairing the small and medium-sized defects of the anterior cheek mucosa.
【作者單位】： 中南大學(xué)湘雅醫(yī)院口腔頜面外科;中南大學(xué)湘雅醫(yī)院手術(shù)室;
【分類號】：R782.2

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