134例头颈部肿瘤手术后缺损修复

目的：分析4种皮瓣修复头颈部缺损的效果、功能、并发症和供区创伤的大小，以为不同的缺损选择不同的皮瓣。方法：134例头颈部肿瘤患者，均行联合根治术加胸大肌肌皮瓣、颈阔肌肌皮瓣、额瓣、前臂皮瓣修复。结果：胸大肌皮瓣全部存活96例，部分坏死21例，坏死≥1／25例，全部坏死2例，颈阔肌皮瓣全部存活2例，部分坏死1例，全部坏死1例，4例额瓣和2例前臂皮瓣全部存活。结论：口腔及颈部大面积缺损需要胸大肌肌皮瓣修复，对需要洞穿修复的，尤其是女性，应尽量避免用胸大肌折叠瓣，可用复合瓣。对一般的口腔缺损用前臂皮瓣修复最为合适。

The Restoration of Head and Neck Defect Caused by Tumor Excision:An Analysis of 34 Cases

Purpose To evaluate a reasonable method about how to select a best prothesis by comparing the effect, function, complication, and the trauma of donor site in four different kind of flap plasty.One hundred and thirty-four cases of head and neck tumor were treated by radical operation with restored pectoralis major myocutaneous flap, or plotysma muscle skin flap, or frontal skin flap. In cases with pectoralis major myocutaneous flap,skin flap was alive in 96 cases, partial necrosis in 21 cases (the range of necrosis more than 1/2 5 cases), whole necrosis in 2 cases; In the cases with plotysma muscle skin flap plasty, 2 were alive, 1 partial necrosis, 1 whole necrosis.Four cases with frontal skin flap,the flaps were all alive. Conclusion]To a large area defect of oral-cavity and neck, greater pectoral muscle skin flap plasty is a good choice;But to penetration defect (especially to women),complex flap rather than pectoralis major myocutaneous flap is an ideal choice.