前臂游离皮瓣功能性修复颌面部缺损的临床体会  

Clinical experience of functional reconstruction of maxillofacial defects with free forearm flap

作　　者：金武龙[1] 叶为民[2] 竺涵光[2] 

机构地区：[1]内蒙古医学院附属医院口腔科,内蒙古呼和浩特010059 [2]上海交通大学医学院附属第九人民医院.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》2010年第1期16-19,共4页China Journal of Oral and Maxillofacial Surgery

基　　金：中国博士后科学基金(20070410691)~~

摘　　要：目的:探讨个体化设计前臂皮瓣修复颌面部缺损,以期达到恢复其解剖形态和生理功能的目的。方法:选择舌癌、颊癌、口底癌患者20例,设计前臂皮瓣时,一是根据缺损大小、形状设计其皮肤外形,二是根据桡动脉和头静脉走行,设计皮下筋膜层外形,包括桡动脉和头静脉在内,大于皮肤范围。术后半个月、3个月、6个月评价修复器官的解剖形态、黏膜化程度、发音清晰度、运动及饮食类型等诸方面生理功能。结果:20例皮瓣全部获得成功,术后半个月和3个月有不同程度的皮瓣外形臃肿,6个月后,修复器官解剖形态无臃肿和牵拉,发音较清晰,感觉功能也有不同程度的恢复,大部分患者(18/20)进普食,少部分(2/20)为软食。结论:皮肤和筋膜下设计前臂皮瓣修复颌面部缺损,可以较好恢复颌面部器官的解剖形态和生理功能。PURPOSE： To study the individual design of free forearm flap for maxillofacial defects to restore their anatomical shape and physiological function. METHODS： Twenty cases of oral cancers in tongue, buccal and floor of mouth were selected. The design of the forearm flap followed the following principles, the shape of the skin was determined by the size and shape of the defect. The subcutaneous fascia shape was designed according to the radial artery and cephalic vein course. The scope included the radial artery and cephalic vein with surrounding tissues. Half a month, 3 months, 6 months after operation, the physiological function was evaluated, which included the anatomical morphology, the degree of mucous membraneous, pronunciation clarity, the mobility of the organ and dietary of the patient. RESULTS： All 20 flaps survived well. Half a month, 3 months after operation, the appearance of the flaps was fat and clumsy in different degrees. 6 months after operation, the shape and function was near normal. Pronunciation was clear and sensation was partly recovered. The majority （17/20） of patients restored normal diet, a small portion （3/20） of patients used soft diet. CONCLUSION： Free forearm flap can be used to repair maxillofacial defect with recovery of anatomical morphology and physiological function.

关 键 词：前臂皮瓣 颌面部缺损 功能性修复 

分 类 号：R782.2.6[医药卫生—口腔医学]