胸锁乳突肌肌骨膜瓣喉气管重建术动物实验与临床应用

为探讨胸锁乳突肌肌骨膜瓣在喉气管重建术中的作用，切除狗环状软骨弓及部分气管前壁造成缺损，取胸锁锁乳突肌肌骨膜瓣修复，分别于术后２个月￣８个月处死动物，观察修复情况，并取材作光镜及扫描电镜检查，结果发现：胸锁乳突肌肌骨瓣膜行喉气管重建具有良好支撑力，修复的呼吸道通畅，无瘢痕及肉芽组织形成，移植骨膜表面为粘膜上皮覆盖，深具有新骨组织形成。临床治疗５例患者，均拔除气管套管，恢复正常呼吸功能。胸锁乳突肌肌

Experimental and clinical studies on sternocleidomastoid myoperiosteal flap for laryngotracheal reconstruction]

In order to explore the value of sternocleidomastoid myoperiosteal flap for laryngotracheal reconstruction, eight dogs were included in the experimental study. After resecting the anterior body of the cricoid cartilage and tracheal tissue, the sternocleidomastoid myoperiosteal flap was used to close the defect immediately. All dogs were killed at two, four, six and eight months after operation. It was found that the sternocleidomastoid myoperiosteal flap had incorporated completely into the defect. Histologic studies by light and scanning electron microscopies showed complete epithelialization with no granuloma formation on surface of the flap and apparent metaplastic new bone formed in the periosteum which was crucial to the stability of the air way and long-term success of the procedure. Five patients who underwent subglottic and tracheal reconstruction with sternocleidomastoid myoperiosteal flap were successfully decannuated and had normal exercise tolerance. The results indicate that the sternocleidomastoid myoperiosteal flap is an ideal transplant for laryngotracheal reconstruction.