带蒂胸锁乳突肌锁骨膜瓣在喉气管缺损修复中的应用  

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

作　　者：刘志[1] 陈文弦[1] 崔鹏程[1] 高鹏飞[1] 罗家胜[1] 仲莉梅[1] 

机构地区：[1]第四军医大学唐都医院耳鼻咽喉科,西安710038

出　　处：《临床耳鼻咽喉头颈外科杂志》2009年第18期821-823,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:观察带蒂胸锁乳突肌锁骨膜瓣作为移植物修复较大范围喉气管缺损的效果。方法:较大范围喉气管缺损患者49例,其中喉气管缺损原因为喉气管狭窄31例,甲状腺癌侵犯气管手术18例。所有患者均采用取带蒂胸锁乳突肌锁骨膜瓣作为移植物修复喉气管缺损,T形硅胶管支撑3～6个月。结果:49例患者全部治愈拔管,恢复正常呼吸功能及功能性发声。随访2～10年,疗效可靠。结论:对于较大范围的喉气管缺损,带蒂胸锁乳突肌锁骨膜瓣取材方便,支撑力强,疗效肯定,是一种理想的移植物。Objective： To investigate the effect of the musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum on the reconstruction of extensiveness laryngotracheal defect. Method： Retrospectively studied 49 patients, who admited in our department from 1996 to 2005 years for severe laryngotracheal defect. There were 28 males and 21 females aged from 15 to 69 years old （mean age was 47 years old）. The causes of laryngotracheal defect were laryngotracheal stenosis（31 cases） and surgery for thyroid carcinoma invading trachea （18 cases）. All of 49 cases were treated with the graft of musculo periosteum flap of the sternocleidomastoideus with clavicular periosteum and placed a silicon T-tube stenting for 3 to 6 months. Result： All of 49 cases were successfully decannulated with recuperative normal airway patency and effective phonation. The follow up ranged from 2 to 10 years, and the effect of operation was steady. Conclusion：The musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum is an ideal graft for the reconstruction of cervical extensiveness tracheal defect.

关 键 词：肌骨膜瓣 胸锁乳突肌 锁骨膜 气管缺损 喉气管重建 

分 类 号：R767.1[医药卫生—耳鼻咽喉科] R562.12[医药卫生—临床医学]