颊脂垫瓣在口腔肿瘤切除后缺损修复中的应用

目的：研究带蒂颊脂垫修补口腔内肿瘤切除后组织缺损的效果。方法：对15例口腔内肿瘤切除后组织缺损的患者,采用颊脂垫瓣修复组织缺损并观察其疗效。结果：术后创口均甲级愈合,6～8周颊脂垫瓣完全上皮化,2月后上皮化粘膜类似正常口腔粘膜。结论：应用颊脂垫瓣修复口腔内肿瘤切除后组织缺损,其操作简单,创伤小,修复功能恢复好,值得临床推广应用。     

无覆盖带蒂颊脂垫瓣在修复口腔缺损中的应用

目的：介绍无覆盖带蒂颊脂垫瓣用于口腔缺损修复的实践。方法：将颊脂垫瓣转移到相应的口腔缺损区,暴露的颊脂垫瓣表面无需植皮,可以自行上皮化。结果：共治疗口腔缺损病例13例,均获成功,颊脂垫瓣封闭效果好。结论：无覆盖带蒂颊脂垫瓣作为局部区域性组织转移瓣,对口腔内颊部、软腭和牙槽等部位软组织缺损的修复尤为适宜,是一种口腔内软组织缺损理想的充填材料。     

颊脂垫瓣移转在腭裂修复中的应用

目的介绍颊脂垫瓣移转的应用原理及用以腭裂修复的实践。方法将颊脂垫瓣移植于硬腭裂隙的口腔侧创面，或充填于腭部的口腔与鼻腔侧组织瓣之间，尤其是硬软腭交界处。颊脂垫不需用皮片覆盖，可以自行上皮化。结果共治疗腭裂６例，术后颊脂垫完全成活，无腭瘘形成，无颊间隙感染发生。２周后，颊脂垫自行上皮化。结论颊脂垫血供丰富，易于成活，可为Ⅱ期愈合的创面提供肉芽组织再生床，改善软硬组织血供，以促进伤口的愈合。使通过常规的手术方法不能或难以修复的大的裂隙或缺损得以修复     

颊脂垫瓣在口腔缺损修复中的应用

目的评价颊脂垫瓣在修复口腔黏膜缺损中的应用。方法1998年5月~2004年7月,收治42例各种原因致口腔缺损患者,其中男26例,女16例,年龄25~76岁。颊部鳞癌7例,颊部白斑5例,软腭部鳞癌7例,腭部腺样囊性癌8例,上颌窦癌6例,上颌齿槽突血管瘤5例,上颌骨角化囊肿4例。病程2个月~10年。缺损部位颊部12例,上颌骨切除导致颊部上分缺损6例,口腔上颌窦瘘17例,软腭部缺损7例。缺损范围3.0cm×3.0cm~6.5cm×4.0cm。均采用颊脂垫瓣修复缺损部位,切取的颊脂垫瓣为颊脂垫的颊突及部分体部。结果术后41例颊脂垫瓣与创面期愈合;1例因缺损大,瓣成形后较薄而期愈合。术后4周水肿消退逐渐上皮化,6周完全上皮化,颊部外观无明显影响。35例获随访3个月~5年,颊脂垫瓣修复区与附近正常黏膜的层次和颜色、弹性、光滑度、质地无明显差异,咀嚼摩擦和食物刺激无明显影响。2例磨牙后区缺损者有轻度张口受限,经过开口训练恢复张口度。结论颊脂垫瓣能较快而有效地修复直径6.5cm以下的黏膜缺损,取材方便,术后无明显的供区并发症,是修复颊部、软腭和牙槽等部位黏膜缺损的理想组织。其缺点为修复范围较局限。     

颊脂垫瓣移转在腭裂修复中的应用

目的介绍颊脂垫辦移转的应用原理及用以腭裂修复的实践。方法将颊脂垫瓣移植于硬腭裂隙的口腔侧创面,或充填于腭部的口腔与鼻腔侧组织辦之间,尤其是硬软腭交界处。颊脂垫不需用皮片覆盖,可以自行上皮化。结果共治疗腭裂6例,术后颊脂垫完全成活,无腭瘘形成,无颊间隙感染发生。2周后,颊脂垫自行上皮化。结论颊脂垫血供丰富,易于成活,可为Ⅱ期愈合的创面提供肉芽组织再生床,改善软硬组织血供,以促进伤口的愈合。使通过常规的手术方法不能或难以修复的大的裂隙或缺损得以修复。     

颊脂垫在腭部缺损修复中的应用

目的:总结颇脂垫用于修复腭部黏膜缺损的临床效果.方法:采用颊脂垫修复18例腭部软组织缺损,观察伤口愈合的时间和组织瓣的外观以及功能恢复情况等.结果:18例创面愈合良好,颊脂垫表面上皮化,修复效果满意,1例出现组织辫臃肿,致使磨牙后区处有咬痕.结论:颊脂垫修复腭部缺损,简便易行,效果良好,是一种较为理想的手术方法.     

颊脂肪垫瓣在修复口腔颌面部缺损中的应用

目的探讨颊脂肪垫瓣在修复口腔颌面部缺损的应用和效果.方法将颊脂肪垫形成一蒂在后方的颊脂肪垫组织瓣转移至缺损区,在无张力下与创缘缝合,表面轻轻用碘仿纱布缝线包压法固定.用以修复口腔颌面部的良恶性肿瘤手术或损伤留下的缺损以及口腔上颌窦瘘共18例.其中修复腭部缺损2例,上颌骨切除后缺损7例,颊黏膜癌切除后缺损3例,颊部良性肿瘤切除后缺损4例,磨牙后区黏表癌切除后缺损1例,封闭拔牙后口腔上颌窦瘘1例.结果术后10 d去除碘仿纱布,见颊脂肪垫轻度水肿,2～4周后水肿明显消退,颊脂肪垫表面逐渐上皮化,6～8周内表面完全上皮化,3个月后再生黏膜与正常口腔黏膜相似.全部病例效果满意,无感染、坏死等并发症发生.结论带蒂颊脂肪垫瓣修复口腔颌面部缺损,方法简单、易行,效果满意,值得推广.     

颊脂垫瓣移转在腭裂修复中的应用

介绍颊脂垫瓣移转的应用原理及用以腭裂修复的实践。方法 将颊脂垫瓣移植于硬腭裂隙的口腔侧创面，或充填于腭部的口腔与鼻腔侧组织瓣之间，尤其是硬软腭交界处。颊脂垫不需用皮片覆盖，可以自行上皮化。结果 共治疗腭裂６例，术后颊脂垫完全成活，无腭瘘形成，无颊间隙感染发生。     

24例颌面部恶性肿瘤术后缺损颞肌瓣即刻修复的临床分析

目的探讨颞肌瓣在口腔颌骨肿瘤术后缺损的即刻修复方法。方法对24例口腔颌骨肿瘤患者,实行肿瘤切除后颞肌瓣即刻修复。结果 24例转移修复的颞肌瓣成活率100％,伤口痊愈,口腔内洞穿缺损消失,颞肌瓣表面在术后2周出现粘膜化。结论颞肌瓣修复口腔颌面部恶性肿瘤术后引起的畸形,手术效果佳,方法简便,创伤小,转移修复的颞肌瓣存活率高。     

应用游离腓骨组织瓣修复口腔肿瘤切除后下颌骨缺损

目的探讨应用游离腓骨组织瓣修复口腔肿瘤切除后下颌骨缺损的临床疗效。方法回顾分析接受游离腓骨组织瓣修复口腔肿瘤切除后下颌骨缺损的临床资料15例。其中下颌骨造釉细胞瘤5例，下颌骨纤维肉瘤2例。颌下腺腺样囊性癌3例，颌下腺粘液表皮样癌2例，口底黏膜高分化鳞癌3例。单纯腓骨骨瓣修复10例，腓骨骨皮瓣修复5例。结果14例腓骨瓣成活，生长良好，1例腓骨骨皮瓣因术后发生血循环危象，经抢救无效而坏死。结论游离腓骨组织瓣修复口腔肿瘤切除后下颌骨缺损可较好地恢复容貌和口腔功能，提高了患者的生存质量。     

Absorption of buccal morphine

The absorption of buccal morphine was compared with that of slow-release morphine sulphate in human volunteers. Morphine concentration was assayed by high pressure liquid chromatography in serum samples obtained at intervals up to 8 hours after administration of morphine 20 mg. Similar mean maximum concentrations were obtained by either route, but the mean time to maximum concentration was longer after buccal than after enteral administration.     

Management of buccal space masses

Lesions in the substance of the cheek--the buccal space--may present diagnostic and management difficulties. The buccal space, that potential fascia space lying within the bulk of the cheek, is anatomically described. While the history and physical characteristics of the buccal mass and selected radiographic and special procedures may suggest a specific cause, the diagnosis is often elusive and requires removal of the mass for histologic evaluation. The surgical approach to a mass in the cheek is governed by its location within the buccal space and by the index of suspicion of malignancy. The preauricular, submandibular approach is the authors' choice for most buccal space lesions. Five case reports are presented to illustrate features in the diagnosis and management of a buccal space mass.     

Anterior lateral thigh flap for buccal mucosal defect after resection of buccal cancer.

OBJECTIVE: To preserve oral function after buccal cancer resection, a free anterior lateral thigh flap (ALTF) was used to cover the buccal mucosal defect. STUDY DESIGN AND SETTING: Nine patients who underwent primary surgical treatment between June 2005 and September 2006 for buccal cancer were enrolled in this study. An ALTF was used to repair the defect immediately after tumor resection. Oral function, including mouth-opening width, oral intake, and teeth cleaning, were compared pre- and postoperatively. RESULTS: No difference was observed in the mouth-opening width between that preoperatively and three months postoperatively (P = 0.54). The oral intake and teeth cleaning also remained unchanged three months postoperatively. CONCLUSION: Repair of a buccal mucosa defect with a free anterior lateral thigh flap is a good alternative for selected patients who undergo resection of buccal cancer; oral function is likely to be preserved.     

Delayed buccal fat pad herniation: An unusual complication of buccal flap in cleft surgery

Buccal musculomucosal flap is commonly used in cleft palate surgery for providing additional lining when nasal mucosa is inadequate. We report an unusual complication of progressively increasing fat herniation from the sutured donor site which started appearing on the third postoperative day. This necessitated excision of the protruding fat pad on the seventh postoperative day. The possible mechanism and precautions for prevention of this complication are discussed.     

Carcinoma of the buccal mucosa.

OBJECTIVE: The goal was to analyze the outcome of surgical therapy for buccal carcinoma. STUDY DESIGN: A retrospective chart review was done. SETTING: The study took place in a major tertiary-care hospital. RESULTS: Twenty-seven patients received first-time surgical therapy for buccal carcinoma. Treatment was surgery alone in 15 and surgery followed by radiation therapy in 6 patients. Six additional patients received surgical salvage for radiation therapy failure. Composite resection of the tumor was performed in 16 patients (59%). Five-year observed actuarial survival rates were 100%, 45%, 67%, and 78%, and locoregional recurrence rates were 0%, 27%, 44%, and 0% for stages I to IV, respectively. The 5-year actuarial survival rates were 80% after surgery and 82% after surgery and postoperative radiation therapy. Patients who underwent surgical salvage after radiation therapy failure had a 1-year survival rate of 0%. CONCLUSION: Aggressive surgical treatment of buccal carcinoma may result in better survival rates. SIGNIFICANCE: The article analyzes buccal carcinoma in regards to the patterns of presentation, treatments rendered, and patterns of failure.     

游离延展上臂外侧皮瓣修复颊癌术后软组织缺损

目的 探讨游离延展上臂外侧皮瓣修复颊癌术后软组织缺损的临床疗效.方法 2011年1月至8月,应用游离延展上臂外侧皮瓣一期修复3例颊癌扩大切除术造成的软组织缺损,术前应用多普勒血流探测仪测量后桡侧副动脉无变异后,根据其走行,以及术中软组织缺损的面积、形态设计皮瓣,皮瓣均越过肱骨外上髁,面积为9 cm ×5 cm～10 cm×6 cm,血管蒂长约10 cm.供区创面直接拉拢缝合.结果 3例皮瓣均成活,其中1例因局部负压过大造成血管危象,经手术探查,减轻局部负压,术后皮瓣逐渐恢复正常.术后随访6～10个月,患者均无复发,颊部外观形态及功能恢复良好,2例供区局部有麻木感,6个月后症状减轻.结论 游离延展上臂外侧皮瓣厚度适宜、血供可靠,是修复颊癌术后软组织缺损的较好方法.     

Microsurgical reconstruction of the buccal mucosa

This article addresses the reconstruction of the buccal mucosa, which is necessary after tumor resection and contracture release.