不同面动脉供血皮瓣重建颊黏膜缺损疗效观察

目的探讨面动脉供血的垂直颈阔肌皮瓣、颏下岛状皮瓣修复颊黏膜癌术后缺损的临床效果。方法颊黏膜癌术后局部软组织缺损患者33例,其中15例以垂直颈阔肌皮瓣修复（颈阔肌组）,18例以颏下岛状皮瓣修复（岛状皮瓣组）;观察并比较2组皮瓣完全成活率、口腔皮肤瘘发生率及功能恢复情况。结果颈阔肌组2组皮瓣部分坏死,完全成活率为86.7%,4例发生口腔颈部皮肤瘘;岛状皮瓣组皮瓣部分坏死1例,完全成活率为94.4%,2例发生口腔颈部皮肤瘘;2组皮瓣完全成活率、口腔皮肤瘘发生率比较差异无统计学意义（P〉0.05）;2组均有轻度张口受限,颈阔肌组口腔功能恢复较好。结论垂直颈阔肌皮瓣与颏下岛状皮瓣均可用于颊黏膜癌术后中小型缺损的重建,但垂直颈阔肌皮瓣术后患者口腔功能恢复优于颏下岛状皮瓣。

Effect of different flaps with blood supply by facial artery on reconstruction of buccal mucosa defect

Objective To explore the effect of vertical platysma myocutaneous flap （VPMF） and submental island flap （SIF） with blood supply by facial artery on reconstruction of the defect after buccal mucosa carcinoma resection. Methods In 33 cases of soft tissue defect after buccal mucosa carcinoma resection, 15 cases received VPMF repair （VPMF group） and 18 received SIF repair （SIF group）. The flap complete survival rate, orocutaneous fistula rate and restoration of oral function were observed and compared between two groups. Results Partial necrosis occurred in 2 cases, with the complete survival rate of 86.7% , and orocutaneous fistula occurred in 4 cases in VPMF group. Partial necrosis occurred in 1 case, with the complete survival rate of 94.4%, and orocutaneous fistula occurred in 2 cases in SIF group. There were no significant differences in the complete survival rate and incidence of orocutaneous fistula between two groups （P〉0.05）. Both two groups had mild restriction of mouth opening. The oral function restoration was better in VPMF group. Conclusions Both VPMF and SIF can be used to repair small to medium buccal defects, but the oral function of patients reconstructed by VPMF is better than that by SIF.