延长垂直下斜方肌岛状肌皮瓣修复巨大口咽缺损

 【目的】探讨下斜方肌肌皮瓣在晚期口咽根治术后巨大口咽部缺损中的应用。【方法】11例晚期口咽部鳞状细胞癌根治术治疗后用颈横动脉供血的延长垂直下斜方肌岛状肌皮瓣修复巨大口咽部缺损。【结果】全部病例无大块皮瓣坏死，无明显肩部功能影响，供区直接拉拢缝合，吞咽和语言功能满意。经4至15个月（平均7．2个月）追踪复查，有4例肿瘤复发。其中1例带瘤生存和3例死亡。[结论]延长垂直下斜方肌肌皮瓣操作较简单可靠，瓣足够大，可作为晚期口咽部鳞状细胞癌手术治疗后巨大口咽部缺损修复的带蒂皮瓣。

Extended Vertical Lower Trapezius Island Myocutaneous Flap for Reconstruction of Extensive Oropharyngeal Defects

[Objective] To explore the application of repairing the extensive oropharyngeal defects produced during the ablation of advanced oropharyngeal cancer. [Methods] Eleven patients (8 males and 3 females ranging in age from 26 to 76 years old, with a mean age of 52.5 years old) with advanced oropharyngeal squamous cell carcinomas were treated at our institution. Extended vertical lower trapezius island myocutaneous flaps based on the transverse cervical artery were used to repair the extensive oropharyngeal defects. Seven patients continued to perform radiotherapy. [Results] No major flap failure and no shoulder dysfunction occurred. The donor sites were closed directly. The functional results in terms of speech and swallowing were satisfactory. The patients were followed for 4 to 15 months (average 7.2 months). One of them was alive with disease and three died. [Conclusion] the extended vertical lower trapezius island myocutaneous flap is a large, simple, and reliable flap, which is preferred for reconstructing extensive oropharyngeal defects following radical surgery for advanced oropharyngeal cancer.