游离股前外侧穿支皮瓣重建头颈肿瘤术后缺损  

Free Anterolateral Thighperforator Flap in postoperative Reconstruction for Head And Neck Tumors

作　　者：苏文玲[1] 赵德安[2] 刘庆华[1] 

机构地区：[1]厦门大学附属第一医院耳鼻咽喉头颈外科,福建厦门361003 [2]中国人民解放军174医院耳鼻咽喉头颈外科,福建厦门361004

出　　处：《中国中西医结合耳鼻咽喉科杂志》2012年第6期440-442,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨应用游离股前外侧穿支皮瓣重建头颈肿瘤切除术后组织缺损的方法及其效果。方法 2006年7月～2011年12月采用游离股前外侧穿支皮瓣修复头颈恶性肿瘤切除术后组织缺损75例,男52例,女23例;最大年龄80岁,最小年龄24岁,其中舌癌42例,颊癌20例,软腭癌2例,扁桃体癌9例,眶部肿瘤l例,外耳道癌1例。组织缺损范围8cm×5cm～18cmx10cm,病程4～24个月。结果 75例应用股前外侧穿支皮瓣游离移植修复,仅2例股前外侧皮瓣远端因静脉回流障碍发生部分坏死,其余均成活,皮瓣成活率97.3%,3例供区部分植皮未成活,延期愈合。术后随访6～24个月,肿瘤无复发,供区外观平整,瘢痕不明显,受区吞咽及言语功能良好,修复重建效果满意。结论游离股前外侧穿支皮瓣制作方便,对供区损伤小,厚薄适中,适宜修复头颈肿瘤切除术后组织缺损。Objective To study the application of free anterolateral thigh perforator flap for reconstruction of head and neck soft tissue defects after tumor resection. Method From July 2006 to December 2011, 75 patients with malignant cancers （52 males, 23females; aged 24-80 years; including 42 squamous cell carcinomas of tongue, 20 buccal cancers, 2 carcinomas of the soft palate, 9 tonsil cancers, 1 orbital tumors, and 1 cancer of external auditory canal） with the soft tissue defects in the head and neck were enrolled in the study. All patients underwent reconstructive operations with the free anterolateral thigh perforator flap after tumor resection. The defects ranged in area from 8 cm ×5 cm to 18 cm ×10 cm in the head and neck for 4 - 24 months. The technique for the anterolateral thigh perforator flap free grafting, and the appearance of the donor and recipient sites, and the influence on the anatomy and fianction in the both local sites were analyzed. Results In the 75 patients, 73 flaps survived completely but two flaps had a partial failure. 72 had a primary wound healing （Stage I ）, and 3 had a delayed wound healing （Stage II）. All the cases were followed up for 6 - 24 months. The flap appearance was good and smooth without any severe scarring, and there was a minimal effect on the function at the donor and recipient sites. Conclusion Because of the less morbidity at the donor site and the better result at the recipient site, of the anterolateral thigh perforator flap flee grafting is a practical technique for reconstruction of the head and neck soft tissue defects after tumor resection.

关 键 词：股前外侧穿支皮瓣 软组织肿瘤 修复 

分 类 号：R739.91[医药卫生—肿瘤]