颈侧皮瓣修复口腔癌术后组织缺损

目的探讨以包含颈外静脉的颈侧皮瓣修复颊癌、舌癌、口底癌及牙龈癌术后软组织缺损的方法。方法根据软组织缺损面积,设计蒂部位于颌后区,包含真皮层、表浅肌肉腱膜系统(SMAS,Superficial Musculoaponeourotic System)层、颈浅筋膜层及颈深筋膜浅层,且包含颈外静脉的皮瓣,待口腔肿瘤切除后,经皮下隧道修复术区缺损。蒂部宽4.0cm,皮瓣最大面积14.0cm×4.0cm。结果临床应用20例,术后1例患者修复区的皮瓣完全坏死,逐步剪除坏死部分,最终血供较好的皮瓣基底部与口底创面愈合,2例皮瓣远端出现部分坏死,经换药去除坏死皮瓣后愈合。结论颈侧皮瓣手术方法简单,取瓣方便,血供较好,皮瓣长宽比较大,适合用于全身状况较差且组织缺损较小的患者。

Lateral neck flap containing external jugular vein with superficial cervical fascia pedicle in construction of oral defects caused by tumor resection

Objective To study the method and feasibility of lateral neck flap containing external jugular vein with superficial cervical fascia pedicle in reconstruction of oral defects.Methods There were twenty oral cancer patients in this group.After the tumor excision,the oral defect was reconstructed with lateral neck flap which had superficial cervical fascia pedicle and contained external jugular vein.Results Only one case failed in this group.The survival rate of the flap was 95%.Two cases encountered patial necrosis but were cured by dressing change. Conclusions Lateral neck flap containing external jugular vein with superficial cervical fascia pedicle had generous blood supply,and it＇s useful in reconstruction of oral tissue defects.