面-颏下动脉岛状瓣在口腔颌面部缺损修复中的应用  

Application of facial⁃submental artery island flap in reconstruction of oral and maxillofacial defects

作　　者：陈伟良[1] CHEN Weiliang(Department of Oral and Maxillofacial Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,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

出　　处：《口腔疾病防治》2022年第1期2-11,共10页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81772888)。

摘　　要：面⁃颏下动脉岛状皮瓣(facial⁃submentalarteryislandflap,FSAIF)是由面动脉⁃颏下动脉供血的筋膜皮瓣,其与口腔颌面部缺损区相邻,其质地、色泽与头面部相似,该瓣血供恒定且血运充分,制备较简单,成活率高,并发症少。根据所携带的组织,FSAIF可分为筋膜皮瓣、肌皮瓣、单纯皮瓣等,该瓣还可制备成带下颌骨的骨筋膜(肌)皮瓣,修复上颌骨缺损。由于其为带蒂瓣,能够大大缩短手术时间、卧床制动时间和住院时间,已被广泛应用于口腔颌面中型缺损修复。医师在使用FSAIF修复口腔颌面部缺损中应严格把握适应证,口腔颌面部良性肿瘤或恶性肿瘤未发生颈淋巴结转移者可安全使用;对于口腔颌面部恶性肿瘤发生颈淋巴结转移但无淋巴结外扩展者,在颈淋巴清扫彻底的前提下可使用该皮瓣。FSAIF修复禁忌证为口腔颌面部恶性肿瘤发生颈淋巴结转移且有淋巴结外扩展,此时,应选择其他组织瓣修复。The facial submental artery island flap(FSAIF)is a fasciocutaneous flap supplied by the facial submental artery.It is in close proximity with many oral and maxillofacial regions,and its tex ture and color are similar to those of the head and face.The flap has a constant and sufficient blood supply,and it is easy to prepare and has high survival rates and few complications.According to the tissue carried,FSAIF can be divided into fasciocutaneous flaps,myocuta⁃neous flaps and simple flaps.The flap can also be made into an osteofasciocutaneous(myocutaneous)flap with a mandi⁃ble to repair maxillary defects.Because this flap is a pedicled flap,it can greatly shorten the operation time,bed rest time and hospitalization time and has been widely used in repairing medium⁃sized defects of the oral and maxillofacial region.The indications for FSAIF in repairing maxillofacial defects should be strictly controlled.It can be safely used for benign or malignant tumors without cervical lymph node metastasis.For malignant tumors with cervical lymph node metastasis but without extranodal extension,the flap can be used on the premise of thorough neck dissection.The con⁃traindication is cervical lymph node metastasis and extranodal extension of malignant tumors,therefore,other flaps should be selected for repair.

关 键 词：颏下动脉岛状皮瓣 面⁃颏下动脉岛状瓣 带蒂瓣 头颈部缺损 口腔颌面部缺损 修复重建 口腔癌 口咽癌 唇癌 颈淋巴结转移 淋巴结外扩展 

分 类 号：R78[医药卫生—口腔医学]