对侧胸锁乳突肌肌蒂锁骨骨膜瓣修复气管壁缺损

目的 根据胸锁乳突肌肌蒂锁骨骨膜瓣的特点，修复颈部肿瘤术后的气管壁缺损。方法 同侧胸锁乳突肌血运因行淋巴清扫或放疗而受损害者，可应用对侧胸锁乳突肌肌蒂锁骨骨膜瓣，充分游离其蒂部，注意保护甲状腺下动脉，用骨膜瓣修复气管壁缺损。结果 本组以对侧骨膜瓣修复气管壁后皆可见上皮化及骨化形成，皆正常拔除气管插管，未见气管狭窄。结论 对侧胸锁乳突肌肌蒂锁骨骨膜瓣可修复患侧胸锁乳突肌血运受损害的气管壁缺损，扩大了肌骨膜瓣的应用范围。

Reconstruction of tracheal defect using the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum

Objective To reconstruct tracheal defect after tumor excision, we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum. Methods The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy. The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully. Results All flaps survived with epithelization and osteogenesis. The endotracheal tubes were pulled out safely without trachea stenosis in all the patients. Conclusions The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged. This method extends the application of the musculo-periosteum flap.;