肩胛骨及邻近瓣在颌面复合缺损修复重建中的应用  

Application of scapula myocutaneous flap or osteomyocutaneous flap to reconstruct maxillofacial defects

作　　者：徐兵[1] 史俊[1] 唐友盛[1] 张志愿[1] 沈国芳[1] 王旭东[1] 卢晓峰[1] 张诗雷[1] 

机构地区：[1]上海第二医科大学附属第九人民医院.口腔医学院口腔颌面外科,上海200011

出　　处：《中国口腔颌面外科杂志》2005年第2期108-112,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨肩胛骨及其复合瓣在颌面部软硬组织缺损修复重建中的应用价值。方法:对12例因不同原因造成部分颌骨及其周围软组织缺损患者实施肩胛骨及其复合瓣修复治疗,术前根据不同部位颌骨、软组织、皮肤缺损量的大小,选择肩胛骨及与其匹配的肌瓣或肌皮瓣;术中顺向或逆向寻找血管蒂,制备肩胛骨及肌瓣或肌皮瓣,吻合血管后,先固定肩胛骨,后关闭软组织。结果:除1例因血管栓塞、修复失败而改用胸大肌皮瓣外,其余11例组织瓣全部成活,咬合关系及外形恢复满意。结论:与其他游离组织瓣相比,肩胛骨及其复合瓣具有切口隐蔽、单一、对供区功能影响小、修复组织范围广等特点,其修复效果令人满意。PURPOSE: In this study, we used the scapula myocutaneous or osteomyocutaneous flaps to reconstruct maxillofacial defects. The merits and details of this method were discussed. METHODS: From 1985 to 2003, 12 patients with maxillofacial defects, resulting from different causes, were reviewed. All cases were treated with scapula myocutaneous or osteomyocutaneous flaps. Based on the various positions and sizes of the defects, the equivalent sizes of the scapula myocutaneous or osteomyocutaneous flaps were chosen and applied. RESULTS: In all of these cases, 11 flaps survived and healed primarily, and 1 case failed with vascular embolization. 11 cases had a satisfactory occlusal relationship and facial contour. CONCLUSIONS: This method showed many advantages: the simple and hidden incision of the donor site, rich blood supply, and large applicable tissues, so it is recommendable to be used clinically. [

关 键 词：修复重建 肩胛骨 复合缺损 周围软组织缺损 硬组织缺损 胸大肌皮瓣 游离组织瓣 复合瓣 应用价值 修复治疗 患者实施 不同原因 不同部位 皮肤缺损 吻合血管 血管栓塞 修复失败 咬合关系 功能影响 修复效果 修复组织 颌面部 

分 类 号：R782.2[医药卫生—口腔医学] R738.3[医药卫生—临床医学]