發(fā)布時間：2018-07-02 14:36

  本文選題：舌及口底缺損 + 面動脈黏膜肌皮瓣��； 參考：《中國修復(fù)重建外科雜志》2017年04期

【摘要】：目的探討采用面動脈黏膜肌皮瓣修復(fù)舌及口底腫瘤切除后缺損的臨床療效。方法 2011年1 月—2016年1 月,采用面動脈黏膜肌皮瓣修復(fù)腫瘤切除后引起舌及口底組織缺損24例。其中男16例,女8例;年齡38~70歲,平均55歲。病程1周~6個月,平均4個月。缺損部位:口底4例,舌15例,口底舌腹5例。其中口底鱗癌2例,口底腺樣囊性癌2例,舌鱗癌14例,舌腺樣囊性癌1例,口底舌腹鱗癌5例。腫瘤切除后舌及口底缺損范圍為4 cm×3 cm~8 cm×7 cm。切取面動脈黏膜肌皮瓣位于原發(fā)灶同側(cè)3例,對側(cè)21例(其中5例因缺損面積較大采用面動脈黏膜肌皮瓣及頦下肌島狀皮瓣共同修復(fù))。面動脈黏膜肌皮瓣切取范圍5 cm×4 cm~5 cm×5 cm,頦下肌島狀皮瓣切取范圍4 cm×3 cm~5 cm×4 cm。結(jié)果術(shù)后所有皮瓣全部成活,無局部壞死發(fā)生。供區(qū)出現(xiàn)傷口裂開5例,經(jīng)局部傷口清洗處理后愈合;余19例供受區(qū)創(chuàng)面Ⅰ期愈合。24例患者均獲隨訪,隨訪時間8個月~5年,平均2年4個月。術(shù)后面部無明顯畸形,無口底漏。術(shù)后16例出現(xiàn)面神經(jīng)下頜緣支損傷臨床表現(xiàn),3個月后恢復(fù)正常。所有患者術(shù)后出現(xiàn)張口受限,1年后20例恢復(fù)正常,4例仍有張口2指受限�；颊哌M食、吞咽、語言等功能均無影響。結(jié)論面動脈黏膜肌皮瓣手術(shù)簡便、整復(fù)效果理想、皮瓣成活率較高、供區(qū)損傷少、術(shù)后護理簡單、術(shù)后無需制動,適宜于舌及口底缺損修復(fù)。
[Abstract]:Objective to investigate the clinical effect of facial artery mucosal myocutaneous flap for repairing tongue and floor tumor after resection. Methods from January 2011 to January 2016, 24 cases of tongue and floor defects were repaired by facial artery mucosal myocutaneous flap. There were 16 males and 8 females, aged 3870 years with an average age of 55 years. The course of disease ranged from 1 week to 6 months (mean 4 months). There were 4 cases in the floor of the mouth, 15 cases in the tongue and 5 cases in the ventral part of the tongue. There were 2 cases of floor squamous cell carcinoma, 2 cases of adenoid cystic carcinoma, 14 cases of tongue squamous cell carcinoma, 1 case of tongue adenoid cystic carcinoma and 5 cases of tongue ventral squamous cell carcinoma. The area of tongue and floor defect after resection was 4 cm 脳 3 cm~8 cm 脳 7 cm. The facial artery mucosal myocutaneous flap was located in the same side in 3 cases and the contralateral in 21 cases (5 cases were repaired with facial artery mucosal myocutaneous flap and submental musculocutaneous flap due to the large area of defect). The area of facial artery musculocutaneous flap was 5 cm 脳 4 cm~5 cm 脳 5 cm, and the submental island flap was 4 cm 脳 3 cm~5 cm 脳 4 cm. Results all the flaps survived and no local necrosis occurred. There were 5 cases of wound dehiscence in donor area, which healed after local wound cleaning, the remaining 19 cases were followed up for 8 months to 5 years (mean 2 years and 4 months). There was no obvious deformity and no leakage of the floor of mouth after operation. The clinical manifestations of mandibular marginal branch injury of facial nerve were found in 16 cases after operation and returned to normal 3 months later. All the patients had limited opening of mouth after operation, 20 cases returned to normal after 1 year, 4 cases still had the limitation of open mouth and 2 fingers. The patients' eating, swallowing, language and other functions were not affected. Conclusion the facial artery mucosal myocutaneous flap is simple and effective, the survival rate of the flap is high, the donor area injury is less, postoperative nursing care is simple, and there is no need for braking after operation, which is suitable for repairing tongue and oral floor defect.
【作者單位】： 桂林醫(yī)學(xué)院附屬醫(yī)院口腔科;
【基金】：桂林市科學(xué)研究與技術(shù)開發(fā)計劃項目(20140310-2-4)~~
【分類號】：R739.8

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