胸大肌肌皮瓣在耳鼻咽喉头颈外科中的应用

目的:探讨胸大肌肌皮瓣在耳鼻咽喉头颈外科手术中的应用方法及临床效果。方法:1983至2001年手术治疗了247例头颈部肿瘤患者,用胸大肌肌皮瓣或联合其它组织瓣如胸三角皮瓣、裂层皮片、喉气管瓣、舌根瓣、胃瓣、胸骨舌骨肌筋膜瓣、胸锁乳突肌骨膜瓣、会厌瓣等对术中组织缺损进行了整复。结果:247例胸大肌肌皮瓣修复术中,肌皮瓣坏死3例,咽瘘31例,切口感染42例,吻合口狭窄4例,严重出血3例。除3例外余者均恢复正常吞咽功能。结论:胸大肌肌皮瓣供血可靠,成活率高,操作简单,能满足头颈部手术中广泛组织缺损的修复和功能重建,使部分晚期头颈肿瘤患者通过手术得以根治,以获得较好的生活质量。

Application of pectoralis major myocutaneous flap in otorhinolaryngology & head and neck surgery

Objective: To explore the methods and effect of pectoralis major myocutaneous flap in head and neck reconstruction. Methods: Two hundred and forty - seven patients with head and neck lesions were operated on from 1983 to 2001 .The surgical procedure was decided on the pathologic conditions. The surgical defects were repaired by pectoralis major myocutanous flap or combined with delto - ectopectoralis flap, split skin flap, laryngotracheal flap, tongue flap, stomach flap, stemohyoid myofascial flap, stemocleidomastoid myoperiosteal flap, epiglottis flap. Results: The flap necrosis occurred in 3 cases, fistular in 31, infection in 42, stenosis of anastomosis in 4, and severe bleeding in 3 . Normal deglutition restored in all cases except 3. Conclusion: Pectoralis major myocutaneous flap is safe and simple to be performed , and can meet most of the reconstruction requirements in head and neck surgery. It will prolong the life - span of patients and improve their living quality.