带蒂胸锁乳突肌肌瓣一期修复腮腺肿瘤术后缺损的疗效  

EFFECTIVENESS OF PEDICLED STERNOCLEIDOMASTOID MUSCLE FLAP IN REPAIRING DEFECT AFTER PAROTIDECTOMY

作　　者：耿中利[1] 李鸿涛[1] 王进[1] 董朝[1] 马斌林[1] 

机构地区：[1]新疆医科大学附属肿瘤医院乳腺、头颈外科,乌鲁木齐830011

出　　处：《中国修复重建外科杂志》2012年第3期313-315,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的通过与直接拉拢缝合比较,探讨带蒂胸锁乳突肌肌瓣修复腮腺肿瘤切除后缺损的疗效。方法回顾分析2002年1月-2010年4月,采用带蒂胸锁乳突肌肌瓣一期修复38例(肌瓣组)腮腺肿瘤切除后缺损患者的临床资料,与同期直接拉拢缝合修复的35例(对照组)患者进行比较。两组患者性别、年龄、病程、肿瘤类型及大小等一般资料比较,差异均无统计学意义(P<0.05),具有可比性。分析两组术后局部凹陷畸形、Frey综合征和腮腺瘘并发症发生情况。结果肌瓣组术后肌瓣均成活,创面Ⅰ期愈合;对照组切口均Ⅰ期愈合。术后两组患者均获随访,随访时间6～98个月。随访期间肿瘤均无复发。术后6个月两组患者面部凹陷畸形程度比较,差异有统计学意义(χ2=53.202,P=0.000)。肌瓣组术后发生1例(2.6%)腮腺瘘,1例(2.6%)Frey综合征;对照组分别为8例(22.8%)及20例(57.1%);两组并发症发生率比较差异均有统计学意义(P<0.05)。结论采用带蒂胸锁乳突肌肌瓣修复腮腺肿瘤切除后缺损,可预防术后局部凹陷畸形、Frey综合征和腮腺瘘并发症的发生。Objective To investigate the effectiveness of pedicled sternocleidomastoid muscle flap in repairing defect after parotidectomy by comparing with direct suture.Methods The clinical data were retrospectively analyzed,which were from 73 patients with parotid tumor undergoing parotidectomy between January 2002 and April 2010.After parotidectomy,defects were repaired with pedicled sternocleidomastoid muscle flap in 38 cases（flap group） and with direct suture in 35 cases（control group）.There was no significant difference in gender,age,disease duration,tumor location and size between 2 groups（P 0.05）.Meanwhile the complications,such as local introcession deformity,Frey＇s syndrome and parotid gland fistula were observed.Results In flap group,the flaps were all alive and incisions healed by first intention;in control group,all incisions healed by first intention.All patients were followed up 6-98 months and no tumor recurred.There was significant difference in local introcession deformity between 2 groups（χ2=53.202,P=0.000）.The parotid gland fistula was found in 1 case（2.6%） of the flap group and in 8 cases（22.8%） of the control group,Frey＇s syndrome was found 1 case（2.6%） of the flap group and in 20 cases（57.1%） of the control group,showing significant differences between 2 groups（P 0.05）.Conclusion The use of pedicled sternocleidomastoid muscle flap for defect repair after parotidectomy can avoid the complications of local introcession deformity,Frey＇s syndrome,and parotid gland fistula.

关 键 词：带蒂胸锁乳突肌肌瓣 腮腺肿瘤 凹陷畸形 FREY综合征 腮腺瘘 

分 类 号：R739.8[医药卫生—肿瘤]