应用游离股前外侧皮瓣重建舌癌术后组织缺损

目的:探讨应用游离股前外侧肌皮瓣修复舌癌术后组织缺损的临床效果。方法 :2008-01—2011-01应用股前外侧肌皮瓣修复舌癌术后组织缺损19例,其中男性11例,女性8例,年龄29岁至65岁,平均年龄50岁。病理类型:高分化鳞癌15例,中分化鳞癌4例。按UICC标准TNM分期:T2N0M0 5例,T3N0M0 8例,T3N1M0 4例,T4N1M0 2例;皮瓣大小为(8 cm×5 cm)^{(15 cm×7 cm)}。结果:19例股前外侧肌皮瓣全部成活,全部病例面颈部创面及大腿皮瓣供区均一期愈合。所有患者舌部缺损修复形态良好,患者语音、咀嚼、吞咽功能恢复良好,手术前后对比,未见明显颌面部畸形。术后随访1(15 cm×7 cm)。结果:19例股前外侧肌皮瓣全部成活,全部病例面颈部创面及大腿皮瓣供区均一期愈合。所有患者舌部缺损修复形态良好,患者语音、咀嚼、吞咽功能恢复良好,手术前后对比,未见明显颌面部畸形。术后随访1³年,1例患者术后1年出现对侧颈部淋巴结及全身骨转移并死亡,余患者未见转移和复发。结论:股前外侧皮瓣组织量丰富,适用于口腔颌面部癌肿术后组织缺损修复及器官功能恢复;因其供区隐蔽,对供区影响小,尤其适合年轻女性患者。

Free Anterolateral Thigh Flap for Reconstruction of Tongue Defects after Carcinoma Ablation

Objective： To evaluate the clinical application benefits of the free anterolateral thigh flap for reconstruction of tongue defects after cancer ablation. Methods： 19 cases from January 2008 to January 2011 were included in the retrospective review. 11 patients were males and 8 were females; the age of the patients ranged from 29 to 65 years with an average of 50 years. Pathological types： 15 cases were highly differentiated squamous cell carcinoma, 4 cases were moderately differentiated squamous cell carcinoma. According to UICC standards TNM staging of patiants as followed 5cases were T2N0M0, 8 cases were T3N0M0, 4 cases were T3N1M0, and 2 cases were T4N1M0. The size of reconstruction flaps ranged from 8 cm×5 cm to 15 cm×7 cm respectively. Results： The flaps in 19 patients all survived. The surgical incisions were healed with first intention. Appearance of the tongue were recovered. Speech, chewing as well as swallowing functions were reconstructed. Without limitation of mouth opening, facial deformity or other complications were observed. All patients were followed up, only 1 patient died after 1 year for carcinoma metastasis to the contralateral neck lymph node and the bone. No other patients showed recurrence or metastasis. Conclusion： The free anterolateral thigh flap is an ideal choice for reconstruction of the oral and maxillofacial defects after cancer ablation. It has many advantages such as abundance volume, little donor site morbidity and easily concealed donor site, especially suitable to young female patients.