改良鼻唇沟岛状皮瓣修复口腔鳞癌切除后软组织缺损  

Application of Modified Nasolabial Island Flap in the Repair of Oral and Maxillofacial Defects

作　　者：伋琳 周航宇 张磊 曾富海 宋梓维 胡明 夏德林 JI Lin;ZHOU Hang-yu;ZHANG Lei;ZENG Fu-hai;SONG Zi-wei;HU Ming;XIA De-lin(Department of Plastic Surgery;Department of Oral and Maxillofacial Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)

机构地区：[1]西南医科大学附属医院烧伤整形外科,四川泸州646000 [2]西南医科大学附属医院口腔颌面外科,四川泸州646000

出　　处：《中国美容医学》2019年第10期86-88,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨改良鼻唇沟岛状皮瓣在修复口腔颌面部缺损的临床效果。方法:选取2016年7月-2018年9月西南医科大学附属医院口腔颌面外科收治的8例口腔颌面部肿瘤切除术后软组织缺损患者。制备以面动静脉为蒂(血管蒂分离至颈外动静脉起始处),根据缺损情况切取岛状鼻唇沟皮瓣。完整切除病变后皮瓣从下颌骨内侧或者外侧转移修复缺损。术后观察皮瓣存活、供瓣区及受区伤口愈合情况,并对患者面部器官外形及功能进行3~24个月的术后随访。结果:8例患者皮瓣全部存活,血运良好。术后随访未出现肿瘤复发,面部器官外形基本正常,功能良好。结论:改良鼻唇沟岛状皮瓣具有操作简单、血供可靠、转移灵活,可同期修复同侧舌、口咽侧壁、口底、牙龈肿瘤切除后缺损,对不适宜行吻合血管游离组织瓣移植患者是理想的选择,值得临床推广应用。Objective To explore the clinical effect of modi fied nasolabial island flap in repairing oral and maxillofacial defects.Methods Eight patients with soft tissue defects after oral and maxillofacial tumor resection in the Department of Oral and Maxillofacial Surgery in Southwestern Medical University Hospital from July 2016 to September 2018 were selected.The preparation was conducted with the facial arteriovenous as pedicle(the vascular pedicle was separated to the beginning of the external carotid vein),and the island-shaped nasolabial fold flap was cut according to the defect.After complete resection of the lesion,the defect repairment was conducted from the medial or lateral mandibular.The survival of the flap and the healing of the wound in donor site and recipient site were observed.The facial shape and function of the patient's facial organs were followed up for 3 to 24 months.Results The flaps of all 8 patients survived and the blood supply was in good order.There was no tumor recurrence in postoperation follow-up.The shape of the facial organs was basically in normal shape and the function was not obviously damaged.Conclusion The improved nasolabial island flap has the advantages of simple operation,reliable blood supply,flexible metastasis.It can simultaneously repair the defect of ipsilateral tongue,oropharyngeal wall,bottom of mouth and defect after gingival tumor resection.It is an ideal choice for patients who are not suitable for free tissue flap transplantation with anastomotic blood vessels,which is worthy of promotion and application.

关 键 词：口腔颌面部 修复重建 岛状鼻唇沟瓣 皮下带蒂皮瓣 软组织缺损 

分 类 号：R139.81[医药卫生—劳动卫生]