应用颊肌黏膜瓣修复腭部缺损

目的 探讨应用颊肌黏膜瓣修复腭部缺损的方法 及效果.方法 修复腭裂时,设计蒂在后的颊肌黏膜瓣,通过翼下颌缝黏膜下隧道修复软硬腭口腔面缺损;腭部肿瘤切除后缺损时,则将该瓣直接转移修复;修补腭裂术后瘘孔时,以蒂在前的颊肌黏膜瓣,通过齿槽裂隙缺损直接覆盖修复.切取最大颊肌黏膜岛状瓣6.0 cm×3.5 cm(成人),供区松解直接闭合.结果 临床应用14例,除1例腭裂术后护理不当软腭有部分复裂,1例远端表皮轻度糜烂外,余12例组织瓣均完全成活.结论 该瓣能Ⅰ期修复腭部肿瘤切除后缺损,功能形态良好,且术后可尽早接受放射治疗,提高了远期疗效;同时对宽大腭裂或腭裂术后并发较大腭前瘘孔,也是一种新的修复术式,且为牙槽嵴裂修复预留软组织床.

Repair of cleft palate with the buccinator musculomucosal flap

Objective To explore the method and effect of repair of palatal defects with the buccinator mus-culomucosal flap. Methods For the cleft palate, the musculomucosal flap with posticous pedicle was designed and transferred through tunnel under the raphe pterygomandibular mucosa to repair oral cavosurface defect of the hard and soft palate; for the defects from tumor resection, the flap was transferred directly to repair the defect; for the postop-erative fistula of cleft palate, the musculomucosal flap with anticous pedicle was used to cover the defect the through alveolar bone defect The biggest size of used flap was 6. 0 cm × 3.5 cm(adult) and the donor site was closed primari-ly. Results Among 14 cases, the flaps in 12 cases survived completely, one case was with part breakdown of soft palate because of mal-postoperative care and the other case was with slight epidermis erosion. Conclusion The axi-al buccinator musculomucosal island flap is not only used to reconstruct the defects after tumer resection of hard or soft palate with good appearance and function but also a better option for the wide cleft palates and the bigger fistula in the anterior palate. Furthermore, it is reserved for reconstruction of alveolar cleft.