游离股内侧嵌合穿支肌皮瓣在舌癌术后缺损修复中的临床应用  被引量:7

Free medial thigh chimeric myocutaneous perforator flap for the reconstruction of tongue defect after tongue carcinoma resection

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作  者:宋达疆[1] 李赞[1] 周晓[1] 章一新[2] 彭小伟[1] 周波[1] 吕春柳[1] 彭文[1] 王旭[1] 欧延[1] 

机构地区:[1]湖南省肿瘤医院肿瘤整形外科湖南省肿瘤整形外科临床医学研究中心,长沙410008 [2]上海交通大学医学院附属第九人民医院整形外科

出  处:《中华耳鼻咽喉头颈外科杂志》2017年第4期278-282,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基  金:湖南省自然科学基金面上项目(13JJ5012);湖南省科技计划项目(2014SK3002);湖南省卫生和计划生育委员会课题项目(B2014-111);湖南肿瘤整形外科临床医学研究中心平台建设专项资助(2013TP4087)

摘  要:目的探讨游离股内侧嵌合穿支肌皮瓣在舌癌术后缺损修复中的应用。方法从2013年6月至2015年11月应用股内侧嵌合穿支肌皮瓣对17例舌癌患者舌颌颈联合根治术后同期行舌及口底缺损修复,口底腔隙同时用肌瓣充填,其中舌缘癌9例,舌腹癌7例,口底癌累及舌1例。观察缺损修复后的形态、功能。结果皮瓣长(9.0±0.3)cm、宽(4.5±0.3)cm、厚(1.8±0.4)cm。以股深动脉来源的股内侧穿支为蒂的嵌合穿支肌皮瓣血管蒂长度为(7.4±0.6)cm。17例嵌合穿支肌皮瓣全部存活,供区均直接闭合。术后随访10~28个月。再造舌形态良好,吞咽、语言功能满意,肿瘤局部无复发。供区仅遗留线性瘢痕,大腿功能未见明显影响。 结论股内侧嵌合穿支肌皮瓣是舌癌术后舌缺损修复的理想选择。Objective To investigate the application of free medial thigh chimeric myocutaneous perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma. Methods From June 2013 to November 2015, 17 cases with tongue carcinoma underwent radical resection and tongue and mouth floor defects after surgery were reconstructed with medial thigh chimeric myocutaneous perforator flaps at the same stage. These 17 cases included tongue carcinoma on lingual margin (n = 9) , ventral tongue ( n = 7 ) and mouth floor ( n = 1 ). Appearance and functional results were evaluated with follow-up. Results Medial thigh chimeric myocutaneous perforator flap was ( 9. 0 ± 0. 3 ) cm in length, ( 4. 5± 0. 3 ) cm in width , and ( 1.8 ±0.4) cm in thickness. The length of pedicle was (7.4 ±0. 6) cm. All of the 17 flaps survived uneventfully, and the donor sites were closed directly in all cases. All patients were followed up for 10 -28 months with satisfied esthetic and functional results in reconstructed tongue. Aside from linear scar in the donor sites, the functions of thighs were not affected. No local recurrence occurred. Conclusion The free medial thigh chimeric myocutaneous perforator flap is an ideal choice to reconstruct the tongue and mouth floor defect after radical resection of tongue carcinoma.

关 键 词:外科皮瓣 修复外科手术 舌肿瘤 

分 类 号:R739.86[医药卫生—肿瘤]

 

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