以颈横动静脉为蒂的延长锁骨上岛状瓣折叠修复口咽瘘

目的:观察以颈横动静脉为蒂的延长锁骨上岛状瓣折叠修复口咽瘘的临床效果.方法:利用以颈横动静脉为蒂的延长锁骨上岛状瓣修复11例口咽癌切除术后出现口咽瘘的患者,评价修复效果.11例患者包括8例男性,3例女性.口咽部瘘口大小3.0 cm×1.5 cm～4.0 cm×2.0 cm,颈部皮肤瘘口10 cm×6 cm～12 cm ×7 cm.结果:11例皮瓣全部成活,无严重并发症.术后随访6～18个月,患者吞咽和言语功能恢复正常,无瘘管复发和咽腔狭窄.患者对术后外形满意.结论:以颈横动静脉为蒂的延长锁骨上岛状瓣是修复口咽瘘有效和安全的方法.

Closure of large oropharyngocutaneous fistulas using a folded extensive supraclavicular fasciocutaneous island flap

PURPOSE：To evaluate the outcomes following the use of folded extensive supraclavicular fasciocutaneous island flaps（SFIFs） to close large oropharyngocutaneous fistulas（OFs）.METHODS：Extensive folded SFIFs were designed to close large OFs following oropharyngeal cancer ablation in 11 patients（8 men,3 women;mean age：53.5 years）.Fistula size ranged from 3.0 cm × 1.5 cm to 4.0 cm × 2.0 cm and skin paddle size ranged from 10 cm × 6 cm to 12 cm ×7 cm.SFIFs provided both inner and outer linings for OFs.RESULTS：All flaps survived,head and neck appearance was satisfactory,and no patient experienced a major complication.All patients resumed an oral diet and eventually regained normal speech function.No fistula recurrence or stricture developed after 6-18 months of follow-up.CONCLUSION：The folded extensive SFIF is a simple and reliable flap preferred for reconstruction of large OFs.