胸锁乳突肌肌皮瓣修复肿瘤术后口底组织缺损的临床疗效

目的:探讨胸锁乳突肌肌皮瓣在肿瘤术后口底组织缺损修复的适应征及临床效果.方法:对32例口腔肿瘤患者在扩大根治术后所致的口底缺损,用胸锁乳突肌肌皮瓣修复.结果:除1例胸锁乳突肌肌皮瓣发生远端部分坏死,肉芽组织生长修复外,其余均成活良好.其中8例出现肌皮瓣表皮脱落后再上皮黏膜化愈合;2例颌下出现少许积液抽取后愈合.随访1～5年,口底形态及功能恢复良好,舌活动良好,未见肿瘤复发或淋巴结转移.结论:胸锁乳突肌肌皮瓣血供恒定,易成活,与肿瘤为同一术野,取用方便,创伤少.掌握好适应证可作为口底缺损功能性修复的有效方法.

Sternocleidomastoid myocutaneous flap for reconstruction after resection of carcinoma in floor of mouth

Objective: To evaluate the clinic outcome and indications of sternocleidomastoid(SCM) myocutaneous flap for reconstruction after resection of carcinoma in floor of mouth.Methods: Thirty-two patients underwent SCM myocutaneous flap for reconstruction of the floor of mouth were reviewed.According to the clinical data and the follow-up,the appearance and function were analyzed.Results: Only one myocutaneous flap was partial necrosis in termination of the flap,and growth with granular.In eight cases,partial epidermal loss over the skin paddle occurred with secondary healing with mucosal epithelium.All patients had oral diet with good separation of the oral floor and the tongue,and had no difficulty in speech intelligibility.The patients' appearance,function and the overall quality of life were improved.Conclusion: The SCM myocutaneous flap appears to be easy to use and suitable for reconstruction of the defect after resection of oral floor carcinoma,the indications of this flap should be selected carefully.