带蒂额肌帽状腱膜裂层颅骨瓣修复前颅底  

Reconstruction of anterior skull base defect by pedicle frontal muscle compound flap

作　　者：张虹[1] 吴宇平[1] 陶远孝[1] 廖文满[1] 吕杨成[1] 胡国华[2] 高国亮 杨桂芬 吴家玉[1] 谭永富 

机构地区：[1]四川省肿瘤医院头颈颅底外科,成都610041 [2]重庆医科大学附属第一医院耳鼻咽喉科 [3]攀枝花钢铁公司攀矿医院 [4]攀枝花钢铁公司总医院 [5]四川省武警消防总队医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉科杂志》2002年第5期370-372,共3页Chinese Journal of Otorhinolaryngology

摘　　要：目的　探讨颅颌面联合手术中前颅底区软硬组织洞穿性缺损Ⅰ期修复重建的方法。方法　采用带血管蒂的额肌帽状腱膜裂层颅骨瓣 ,该瓣的血管蒂可为双蒂也可为单蒂。在术中Ⅰ期修复重建了 12例前颅底区软、硬组织缺损。取瓣面积可达 8cm× 15cm左右。结果　用该瓣修复的12例患者无颅内感染和脑脊液漏等并发症发生 ,伤口全部Ⅰ期愈合。 9例恶性肿瘤患者随访 2年以上 8例 ,存活 2年的 5例。结论　带蒂额肌帽状腱膜裂层颅骨瓣血管恒定、血供好、组织薄软、带颅骨外板使其支撑力度强又可弯曲成型 ,取瓣径路与术野一致 。Objective To evaluate the effect of one stage reconstruction for anterior skull base defect by pedicled frontal muscle compound flap after craniofacial combined approach operation. Methods Twelve patients with frontal skull base tumor and fracture (rudimentary cancer 5,malignant melanoma 1, neurogliocytoma l, ethmoid sinus rhabdomyosarcoma 1, malignant papilloma 1, osteofibroma 2, underwent surgery 1) were included. The compound flap with pedicled frontal muscle galea aponeuroses pericranium was adopted which brought single blood vessel or double, and splinter skull bone. The compound flaps covered 8cm～12cm×10cm～15cm. Results All 12 patients were successfully treated with no complication during follow-up from 1 to 48 months. Conclusion The compound flaps with pedicled frontal muscle galea aponeuroses pericranium had ample blood supply and thin pliable and strong tissue which was a good reconstruction material for frontal skull base defect.

关 键 词：颅底修复 外科手术方法 骨重建 带蒂额肌帽状腱膜裂层颅骨瓣 

分 类 号：R651.1[医药卫生—外科学]