耳前窄蒂侧颌颈皮瓣修复面部缺损

目的探讨侧颌颈皮瓣的设计应用及血供类型.方法设计蒂部位于耳前的由颌缘走向颏下的窄蒂皮瓣,用于中老年面部恶性肿瘤切除后软组织缺损的修复.皮瓣最大10 cm×6 cm,蒂宽2.5～3.0 cm,长2～4 cm.结果本组4例,面部恶性肿瘤切除后应用改进设计的侧颌颈皮瓣修复创面,全部获得成功,术后外形良好,供区直接松解缝合,肿瘤无复发.结论侧颌颈部皮瓣应属于跨区供血皮瓣.设计时宜斜行走向,蒂部不宜过窄,供区可直接闭合,解剖层次表浅,手术时间短,同时为患者提供术后及早的综合性治疗,如放疗,是中老年患者面部恶性肿瘤切除创面修复的理想选择.

Preauricular lateral maxillocervical fasciocutaneous flap

OBJECTIVE: To investigate the design and blood supply type of the reverse narrow pedicle lateral maxillocervical fasciocutaneous flap. METHODS: The reverse narrow pedicle lateral maxillocervical fasciocutaneous flap with its pedicle locate in front of auricle was designed to repair the defect caused by removing the malignant tumor in aged patients. The largest size is about 10 cm x 6 cm, the width of pedicle ranged from 2.5-3.0 cm, 2-4 cm in length. RESULTS: The flaps were used in 4 patients, age from 57 to 83 years old and the flap was designed as lateral maxillocervical fasciocutaneous flap. The flap was survived well in all patients, donor site can be closed without strain, no tumor relapsed. CONCLUSION: The flap should be included to be a reverse axial flap and it should be designed from jaw edge to chin. The pedicle couldn't be too narrow, in this way, donor site can be closed directly, and less surgical operation time needed. The patients can accept synthesize treatment early, for example actinotheraphy. It is an ideal choice for repair the defect caused by removing the malignant tumor in aged patients.