CTA三维重建技术辅助股前外侧穿支皮瓣再造舌13例  

Repair of significant tongue defect after tongue cancer radical resection using anterolateral thigh perforator free flap with CTA three-dimensional reconstruction technique assistance： A report of 13 cases

作　　者：韦平欧[1] 谭海涛[1] 莫勇军[1] 杨克勤[1] 谭汉提[1] 罗翔[1] 林汉[1] 韦堡升[1] 

机构地区：[1]贵港市人民医院手足显微骨科,广西壮族自治区贵港市537100

出　　处：《中华显微外科杂志》2017年第4期333-336,共4页Chinese Journal of Microsurgery

基　　金：广西科技厅重大疾病防治新技术研究开发项目（桂科攻1355005-7-3）

摘　　要：目的探讨在CTA三维重建技术辅助下应用股前外侧穿支皮瓣游离移植修复行舌癌根治术后舌大部分缺损的临床效果。方法2012年1月至2015年11月．对13例舌癌根治术造成舌大部分缺损患者实施股前外侧穿支皮瓣游离移植进行舌再造。术前将皮瓣供区进行CT扫描，通过CT血管造影数字化三维重建技术获得供区动脉血供三维图像，明确股前外侧皮瓣血供的起源、走向、分型、血管蒂长度、管径以及穿支点位置。根据舌体缺损情况．设计股前外侧穿支皮瓣面积10cm×9cm～8cm×6cm，皮瓣动、静脉分别与面动脉或甲状腺上动脉．与面前静脉、颈内静脉或颈外静脉吻合。术后定期随访，观察再造舌的外形与功能恢复情况。结果13例皮瓣全部成活．术后经4～18个月的随访，再造舌体组织接近正常，咀嚼、进食及功能满意。结论CTA三维重建技术辅助股前外侧穿支皮瓣移植再造舌的临床效果良好．是修复舌癌根治术后舌大部分缺损的较好方法之一。Objective To report the clinical effect of repair of significant tongue defect after tongue cancer rad- ical resection using anterolateral thigh perforator free flap with CTA three-dimensional reconstruction technique assistance. Methods From January, 2012 to November, 2015, 13 cases were performed using anterolateral thigh perforator free flap in the repair of significant tongue defect after tongue cancer radical resection. Preoperation CT scan of the free flap donor site was done to obtain the three-dimensional images of arterial blood area by Digital Three-dimensional Reconstruction CT Technique to determine the origin of the anterolateral thigh flaps, direction, classification, length, diam- eter and the position of pedicle perforator. According to the condition of the defect of the tongue, flap of area from10 cm× 9 cm to 8 cm×6 cm was design, the flap arteries and veins were anastomosed with the external maxillary artery or the superior thyroid artery, anterior vein, internal jugular vein or external jugular vein respectively. The shape and recovery of function of the reconstructed tongue were observed regularly after operation. Results All the flaps in the 13 cases survived, in the postoperative 4 to 18 months followed up ,the appearance of the reconstructed tongue was close to the normal one, the patients were satisfied with the mastication and feeding function. Conclusion CTA three--dimensional reconstruction technique assisted anterolateral thigh perforator free flap technique is useful in obtaining good clinical effect, and it is one of the most best methods for repairing significant tongue defect after tongue cancer radical resection.

关 键 词：舌 再造 股前外侧穿支皮瓣 CTA技术 显微外科手术 

分 类 号：R739.86[医药卫生—肿瘤]