颧眶动脉穿支蒂颞部岛状皮瓣修复眼周恶性肿瘤切除术后缺损  

Effectiveness of temporal island flap pedicled with perforating branch of zygomatic orbital artery to repair the defects after periocular malignant tumor resection

作　　者：张其 唐修俊 王昊玉 李丰 龙艳[1] 刘航 莫小金 ZHANG Qi;TANG Xiujun;WANG Haoyu;LI Feng;LONG Yan;LIU Hang;MO Xiaojin(Department of Medical Cosmetology,Guizhou Provincial People's Hospital,Guiyang Guizhou,550002,P.R.China)

机构地区：[1]贵州省人民医院医学美容科,贵阳550002

出　　处：《中国修复重建外科杂志》2023年第4期469-472,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结颧眶动脉穿支蒂颞部岛状皮瓣修复眼周恶性肿瘤切除术后缺损的疗效。方法2015年1月—2020年12月,收治15例眼周恶性肿瘤患者。男5例,女10例;年龄40~75岁,平均62岁。基底细胞癌12例,鳞状细胞癌3例。病程5个月~10年,中位病程2年。肿瘤范围1.0 cm×0.8 cm~2.5 cm×1.5 cm,均未侵犯睑板。术中肿瘤扩大切除后遗留缺损范围为2.0 cm×1.5 cm~3.5 cm×2.0 cm。采用颧眶动脉穿支蒂颞部岛状皮瓣经皮下隧道转移修复眼周缺损,皮瓣切取范围为3.0 cm×1.5 cm~5.0 cm×2.0 cm。供区皮下分离后直接缝合。结果术后15例皮瓣均顺利成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合。患者均获随访,随访时间6~24个月,中位时间11个月。皮瓣无明显臃肿,质地、颜色与周围正常皮肤基本相同,术区瘢痕隐蔽;无上睑下垂、眼睑外翻、眼睑闭合不全等并发症发生。随访期间肿瘤无复发。结论颧眶动脉穿支蒂颞部岛状皮瓣能修复眼周恶性肿瘤切除后遗留的较大缺损,具有血供可靠、设计灵活以及术区形态、功能佳等优点。Objective To summarize the effectiveness of the temporal island flap pedicled with the perforating branch of zygomatic orbital artery for repairing defects after periocular malignant tumor resection.MethodsBetween January 2015 and December 2020,15 patients with periocular malignant tumors were treated.There were 5 males and 10 females with an average age of 62 years(range,40-75 years).There were 12 cases of basal cell carcinoma and 3 cases of squamous carcinoma.The disease duration ranged from 5 months to 10 years(median,2 years).The size of tumors ranged from 1.0 cmx0.8 cm to 2.5 cmx1.5 cm,without tarsal plate invasion.After extensive resection of the tumors,the left defects in size of 2.0 cm×1.5 cm to 3.5 cm×2.0 cm were repaired with the temporal island flap pedicled with the perforating branch of zygomatic orbital artery via subcutaneous tunnel.The size of the flaps ranged from 3.0 cm×1.5 cm to 5.0 cm×2.0 cm.The donor sites were separated subcutaneously and sutured directly.ResultsAll flaps survived after operation and the wounds healed by first intention.The incisions at donor sites healed by first intention.All patients were followed up 6-24 months(median,11 months).The flaps were not obviously bloated,the texture and color were basically the same as the surrounding normal skin,and the scars at recipient sites were not obviously.There was no complication such as ptosis,ectropion,or incomplete closure of the eyelids and recurrence of tumor during follow-up.Conclusion The temporal island flap pedicled with the perforating branch of zygomatic orbital artery can repair the defects after periorbital malignant tumors resection and has the advantages of reliable blood supply,flexible design,and good morphology and function.

关 键 词：眼周缺损 颧眶动脉 穿支皮瓣 恶性肿瘤 创面修复 

分 类 号：R622[医药卫生—整形外科]