应用岛状颊肌粘膜瓣修复腭裂初步报告

目的：介绍应用岛状颊肌粘膜瓣修复腭裂的临床实践。方法：应用裂缘葶粘骨膜瓣闭合硬腭裂隙的鼻腔侧、软腭后推、软腭鼻侧粘膜Z成形术延长、腭帆提肌吊带重建，再以蒂在后的血管神经蒂岛状颊肌粘膜瓣修复软腭后推后在腭部遗留的横行创面和硬腭裂隙的口腔侧创面。结果：1997年以来共治疗12例，术后岛状颊肌粘膜瓣完全成活，软腭延长显著，无腭瘘形成，无血肿、感染、肋腺导管和面神经损伤及开口功能障碍等并发症发生。结论：岛状颊肌粘膜瓣血运好，易成活；术后早期不需配戴牙垫，不影响恒磨牙的萌出，不干扰咬合，无埯断蒂，不破坏翼下颌皱襞形态和结构，供区易于缝合，感觉功能好。

The buccinator myomucosal island flap for cleft palate repair

Objective The purpose of this paper is to provide the experience in using the buccinator myomucosal island flap in cleft palate. Methods The nasal cleft of the hard palate is closed with the mucoperiosteal flaps based on the edge of the hard palate cleft. The nasal mucosa of the soft palate is lengthened by a Z plasty. The levator veli palatini muscle sling is reconstructed. The soft palate is pushed back. A buccinator myomucosal neurovascular island flap is passed through the tunnel under the pterygomandibular ligament to the palate to close the defect in the oral side. Results The procedure was performed on 12 patients. The postoperative course were uneventful. The buccinator myomucosal island flap is viable without fistula,infection, hematoma, occlude disturbance, facial nerve injury,parotid duct injury or obstruction. Conclusions The buccinator myomucosal island flap is very useful, particularly for closure of large clefts. The flap has stable blood supply. The buccal island flap is passed through the tunnel under the pterygomandibular ligament,which avoids the second operation of pedicle division and flap resetting.