以舌前为蒂的舌背黏膜瓣修复大型前腭瘘的临床效果  

Clinical effect of reconstruction of large anterior palatal fistulae by anteriorly based dorsal tongue flaps

作　　者：黄卓珊[1] 温作珍[1] 房思炼[2] 钟江龙 陈伟良[1] HUANG Zhuoshan;WEN Zuozhen;FANG Silian;ZHONG Jianglong;CHEN Weiliang(Department of Oral and Maxillofacial Surgery,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China;Department of Oral and Maxillofacial Surgery,The Sixth Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510655,China)

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面外科,广东广州510120 [2]中山大学附属第六医院口腔颌面外科,广东广州510655

出　　处：《口腔疾病防治》2019年第3期185-188,共4页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省医学科学技术研究基金项目(2017116172920681)

摘　　要：目的评估利用以舌前为蒂的舌背黏膜瓣修复大型前腭瘘可行性和临床效果,为舌背黏膜瓣的临床应用提供参考。方法 5例前腭瘘患者,缺损范围1.0 cm×1.0 cm～1.5 cm×2.0 cm,前舌瓣大小1.3 cm×3.5 cm～2.0 cm×3.5 cm,均采用以舌前为蒂的舌背黏膜瓣修复。术后进行临床疗效评价,包括黏膜瓣有无感染坏死、断蒂前有无脱落、术后有无腭瘘穿孔。随访患者对咀嚼、吞咽、言语功能、外观是否满意。结果所有患者均采用以舌前为蒂的舌背黏膜瓣成功修复腭缺损,且无舌瓣自发性分离。随访16～28个月,均无腭瘘穿孔。手术对舌的语言、搅拌和吞咽功能均无影响,患者对外观满意。结论以舌前为蒂的舌背黏膜瓣是一种修复大型前腭瘘的安全可靠的术式。Objective To evaluate the feasibility and outcomes of the reconstruction of large anterior palatal fistulae by anteriorly based dorsal tongue flaps to provide a rational reference of anteriorly based dorsal tongue flaps for clinicians.Methods Five patients with anterior hernia had a defect range of 1.0 cm×1.0 cm to 1.5 cm×2.0 cm,and the anterior tongue was 1.3 cm×3.5 cm to 2.0 cm×3.5 cm.The defects were all repaired with anteriorly based dorsal tongue flaps.The clinical efficacy was evaluated after operation,including whether the mucosal flap was infected,whether there was any shedding before the pedicle,and whether there was any perforation after operation.Thereafter,patients who were satisfied with their chewing,swallowing,speech function and appearance were followed up.Results All patients underwent successful reconstruction of palatal defects by anteriorly based tongue flaps,and no case of spontaneous detachment of the tongue flap occurred.Patients with palatal fistulae were followed up for 16-28 months,and no recurrence was encountered.The operation had no effect on the speech,agitation and swallowing function of the tongue,and patients were satisfied with the appearance.Conclusion The dorsal lingual mucosal flap pedicled with the anterior tongue is a safe and reliable method for repairing large anterior palatal fistula.

关 键 词：前腭瘘 腭裂 舌 舌瓣 缺损修复 穿孔 

分 类 号：R782[医药卫生—口腔医学]