折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘8例报道

目的:探讨应用折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘的临床效果。方法:8例（男7例,女1例;年龄46~65岁,平均年龄57.6岁）全喉切除术后巨大咽皮瘘患者,咽皮瘘直径2.0 cm×1.8 cm~4.5 cm×3.0 cm,采用折叠延长下斜方肌岛状皮瓣修复。皮岛宽5~9 cm,长10~23 cm,折叠修复咽皮瘘,恢复咽腔内衬里及外侧皮肤。结果:8例皮瓣全部成活,患者无继发咽皮瘘与咽狭窄,吞咽功能满意。结论:折叠延长下斜方肌岛状肌皮瓣可作为修复全喉切除术后巨大咽皮瘘的首选皮瓣,其操作简便,安全可靠。

Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae after salvage total laryngectomy in 8 consecutive cases

PURPOSE: To explore the feasibility of using folded extended vertical lower trapezius island myocutaneous flap(TIMF) for reconstructing large pharyngocutaneous fistulae developing after salvage total laryngectomy. METHODS: Eight （7 males and 1 females, 46 to 65 years of age, with a mean age of 57.6 years) large pharyngocutaneous fistulae, 2.0 cm×1.8 cm-4.5 cm×3.0 cm in size, were reconstructed following salvage total laryngectomy using folded extended vertical lower TIMF. The skin paddle of the extended vertical TIMF flap was 5-9 cm wide and 10-23 cm long. The folded flap provided both inner and outer linings for pharyngocutaneous fistulae. RESULTS: All flaps survived well. No fistula recurrence or stricture developed. Swallowing function was satisfactory. CONCLUSIONS: Folded extended vertical lower TIMF is a large, simple, and reliable flap preferred for reconstructing large pharyngocutaneous fistulae developing after salvage total laryngectomy.