颏部岛状组织瓣功能性修复全下唇缺损的临床观察

目的 探讨全下唇缺损的功能性修复方法并观察其临床效果.方法 6例下唇癌患者行外科手术治疗,术后下唇缺损4/5至全下唇缺损,设计以双侧颏神经血管束为蒂的颏部岛状组织瓣V-Y推进修复下唇全厚缺损,重建口轮匝肌.结果 术后组织瓣全部成活,随访3～14个月,肿瘤均无复发,唇外观良好,张口度接近正常,同时保留了良好的口周括约肌功能和口唇黏膜的正常感觉功能.结论 对于局限于唇红或唇红缘下方1 cm内的全下唇缺损,双侧须神经血管束为蒂的颏部岛状组织瓣V-Y推进修复方法是比较理想的功能性重建方法.

Functional reconstruction of total lower lip defect with mental neurovascular V-Y advancement island flap

Objective To introduce a method of functional reconstruction for total lower lip defects.Methods Six patients with lower lip cancer were treated by surgery from November 2007 to February 2009.The full thickness defects with a size from eighty percent to total lower lip were reconstructed with two triangular mental neurovascular island flaps of chin.The musculocutaneous and mucous flaps with neurovascular pedicles were advanced in a V-Y manner to close the defect and reconstruct the orbicularis oris muscle.Results All flaps survived and no recurrence and complication were observed and showed excellent cosmetic and functional results over 6 months of follow-up.The reconstructed lower lips provided a wide-enough mouth opening,and the sensation of oral mucosa and the muscle function of oral sphincter were preserved.Conclusions The technique of mental neurovascular V-Y advancement island flap can get satisfactory results in both functional and the aesthetic perspects.