颈阔肌肌皮瓣修复口腔癌术后组织缺损

目的探讨颈阔肌肌皮瓣修复口腔癌术后组织缺损的方法及可行性。方法2003年3月~2004年6月,应用颈阔肌肌皮瓣修复舌、口底、颊、咽侧壁及软腭缺损15例。其中男12例,女3例,年龄41~77岁。颊癌11例,舌癌1例,口底癌2例,咽侧壁及软腭癌1例。均行病变及颈淋巴根治性切除,缺损范围3.0 cm×3.5 cm~7.0 cm×4.0 cm,应用颈阔肌皮瓣修复软组织缺损,皮瓣范围7.0 cm×3.5 cm~12.0 cm×4.0 cm。结果术后15例皮瓣均成活,肌皮瓣色泽与皮肤相似,外形无异常,张口不受限。术后10~15 d出现颊部皮瘘8例,术后4周二期断蒂修补后完全愈合。随访6~12个月,无舌运动受限等并发症,肿瘤无复发,患者对术后形态及功能均较满意。结论颈阔肌肌皮瓣血运丰富,抗感染力较强,成活率高,是修复口腔组织缺损行之有效的方法,手术方法简便,值得推广。

PLATYSMA MYOCUTANEOUS FLAPS IN RECONSTRUCTION OF ORAL DEFECT CAUSED BY TUMOR RESECTION

OBJECTIVE: To study the method and feasibility of platysma myocutaneous flap in reconstruction of oral defects. METHODS: From March 2003 to June 2004, 15 patients with defects of tongue, floor of mouth, bucca, lateral pharynx and soft palate were treated with platysma myocutaneous flaps. There were 12 males and 3 females with an age range of 41-77 years. Defect was caused by resection of buccal (11 cases), tongue (1 case), floor of mouth (2 cases)and lateral pharyngeal and soft palate (1 case) squamous cell carcinoma. All patients were given primary cancer dissection and radical neck dissection. The defect sizes were from 3.0 cmX 3.5 cm to 7.0 cm X 4.0 cm. The sizes of the platysma myocutaneous flap were from 7.0 cm x 3.5 cm to 12.0 cm x 4.0 cm. RESULTS: All the patients were followed up for 6-12 months. In 15 patients, the flap survived, and the color and appearance of the flaps were normal. Mouth-opening was not limited. Eight patients had cutaneous fistula after 10-15 days of operation and were cured by secondary operation. No complication of ankyloglossia and tumor relapse occurred. The operation results were satisfactory. CONCLUSION: Platysma myocutaneous flap has generous blood supply, it is useful in reconstruction of oral tissue defects.