锁骨上岛状皮瓣在腮腺区及耳廓区肿瘤手术修复中的应用  

Application of supraclavicular fasciocutaneous island flap for reconstruction after removal of tumors in parotid and auricle area

作　　者：骆宇超 唐青来[1] 杨新明[1] 肖自安[1] 朱刚才[1] 尹丹辉 杨倩[1] 黄佩颖 曾诗颖 李仕晟[1] Luo Yuchao;Tang Qinglai;Yang Xinming;Xiao Zian;Zhu Gangcai;Yin Danhui;Yang Qian;Huang Peiying;Zeng Shiying;Li Shisheng(Department of Otorhinolaryngology Head and Neck Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院耳鼻咽喉头颈外科,长沙410011

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第5期486-491,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：长沙市科技厅(kq1901121)。

摘　　要：目的探索锁骨上岛状皮瓣(supraclavicular fasciocutaneous island flap,SIF)在腮腺区及耳廓区肿瘤切除后缺损修复中的应用。方法回顾性分析2019年2月至2021年6月中南大学湘雅二医院耳鼻咽喉头颈外科应用SIF修复腮腺区及耳廓区肿瘤术后颜面部缺损的12例患者的临床资料,男性11例,女性1例,年龄54~77岁。其中腮腺腺样囊性癌4例,耳廓基底细胞癌8例。记录皮瓣大小、切取时间、颈部淋巴清扫情况及术后并发症等。结果12例皮瓣面积为(6~9)cm×(8~13)cm,皮瓣制备时间为40~80 min,平均51.7 min;肩部供区皮肤均直接拉拢缝合。所有患者均行同侧的Ⅰ~Ⅲ区颈部淋巴清扫术,其中4例增加Ⅳ区颈清扫,2例增加Ⅳ~Ⅴ区颈清扫。12例患者中10例皮瓣完全存活,2例发生皮瓣远端部分坏死;1例出现供区创口裂开。术后随访10~42个月,10例患者随访期间未见肿瘤复发;1例患者术后10个月失访;1例患者术后11个月肿瘤原位复发,术后15个月死亡。结论SIF具有易于获取、皮肤特征与腮腺区及耳廓区匹配好、供区损伤小、无须显微血管吻合技术等特点,用于修复腮腺区及耳廓区缺损的可行性及疗效良好。Objective To evaluate the efficacy of supraclavicular fasciocutaneous island flap(SIF)for repairing the defect of parotid or auricle regions after tumor resection.Methods From February 2019 to June 2021,12 patients(11 males and 1 female,aged 54-77 years old),of whom 4 with parotid adenoid cystic carcinoma and 8 with auricular basal cell carcinoma underwent reconstruction surgery for postoperative defects in the parotid gland area and auricular area with SIF in the Department of Otorhinolaryngology Head and Neck Surgery,the Second Xiangya Hospital of Central South University and their clinical data were retrospectively analyzed.Size of the SIF,time for harvesting SIF,neck lymph node dissection and postoperative complications were recorded.Results The flap areas were(6-9)cm×(8-13)cm,and the harvesting time for SIF ranged from 40 to 80 min,averaging 51.7 min.The donor sites were directly closed.All patients underwent ipsilateral levelsⅠ-Ⅲneck dissection,with 4 cases undergoing additional levelⅣneck dissection and 2 cases undergoing levelⅣ-Ⅴneck dissection.Of the 12 SIF,10 were completely survival and 2 had flap arterial crisis with partial flap necrosis,in addition,1 had donor site wound dehiscence.With follow-up of 10-42 months,there were no tumor recurrences in 10 patients,1 patient was lost to follow-up at 10 months postoperatively,and 1 patient experienced local tumor recurrence at 11 months after surgery and died 15 months later.Conclusion SIF is an easily harvested flap with good skin features matching the skin in parotid and auricle regions and less damage to donor site,and this flap has no need for microvascular anastomosis technique.SIF is feasible and effective for repairing defects in parotid and auricle area.

关 键 词：外科皮瓣 头颈部肿瘤 修复外科手术 锁骨上岛状皮瓣 

分 类 号：R739.61[医药卫生—肿瘤]