鼻唇沟岛状皮瓣在口底组织缺损修复重建中的应用  

CLINICAL APPLICATION OF NASOLABIAL ISLAND PEDICLED FLAP FOR REPAIRING MOUTH FLOOR DEFECTS

作　　者：胡小华[1] 黄桂林[1] 张霓霓[1] 易杰[1] 姚礼[1] 张林[1] 

机构地区：[1]遵义医学院附属口腔医院颌面外科,贵州遵义563000

出　　处：《中国修复重建外科杂志》2014年第6期710-713,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨鼻唇沟岛状皮瓣修复口底组织缺损的疗效。方法 2010年7月-2013年7月,采用以面动脉下端为蒂的鼻唇沟岛状皮瓣修复口底组织缺损13例。男7例,女6例;年龄36~73岁,平均58岁。缺损均为病变切除所致,其中白斑4例,红斑2例,舌下腺黏液表皮样癌1例,口底癌2例,舌癌4例。单纯口底缺损5例;合并舌体缺损6例,牙龈缺损2例。其中6例仅累及黏膜及黏膜下层,7例累及舌下腺及舌肌或牙槽突。口底组织缺损直径1~4 cm,皮瓣切取范围为4.5 cm×2.0 cm^6.5 cm×3.5 cm。结果患者均顺利完成手术,皮瓣均成活,供、受区创面均Ⅰ期愈合。13例均获随访,随访时间5~24个月,平均11个月。未见肿瘤复发;患者进食、吞咽、语言等功能接近正常。供区无明显畸形。结论鼻唇沟岛状皮瓣移位灵活、操作简便、成活率高、供区损伤小,适宜于口底轻中度缺损修复。Objective To investigate the effectiveness of nasolabial island pedicled flap in repairing mouth floor defects. Methods Between July 2010 and July 2013, 13 cases of mouth floor defects were repaired with nasolabial island pedicled flap. There were 7 males and 6 females, aged 36-73 years （mean, 58 years）. Defects were caused by lesion resection, including 4 cases of leukoplakias, 2 cases of erythema, 1 case of mucoepidermoid carcinoma, 2 cases of the month floor cancer, and 4 cases of tongue cancer. The locations of defects were the mouth floor in 5 cases, the mouth floor and tongue body in 6 cases, and the mouth floor and gingival in 2 cases; the mucosa and submucosa were involved in 6 cases, and the sublingual gland, tongue muscle or alveolar process in 7 cases. The size of defect was 1-4 cm. The size of the flaps ranged from 4.5 cm x 2.0 cm to 6.5 cm x 3.5 cm. Results The operation was successfully performed in all patients; the flaps survived; and the primary healing of incisions at donor site and recipient site were obtained. Thirteen patients were followed up 5-24 months （mean, 11 months）. No tumor recurrence was observed; the patients had normal functions of eating, swallowing, and speech. The facial appearance was satisfactory. No obvious deformity was observed at donor sites. Conclusion The nasolabial island pedicled flap is fit for repairing small or middle sized defects of the mouth floor, and it has the advantages of flexible flap transplantation, less injury at donor site, easy operation, and high flap survival rate.

关 键 词：鼻唇沟岛状皮瓣 口底组织缺损 创面修复 

分 类 号：R782[医药卫生—口腔医学]