摘要
目的探讨游离腓动脉双叶穿支皮瓣修复颌面部恶性肿瘤术后缺损的效果。方法回顾性分析2018年1月至2021年12月, 南通大学附属医院收治的采用游离腓动脉双叶穿支皮瓣修复颌面部恶性肿瘤术后缺损患者临床资料。手术切除肿瘤组织后, 以左腿为主要供区, 根据颌面部缺损面积, 设计和制备腓动脉双叶穿支皮瓣修复肿瘤切除后的组织缺损。术后随访观察患者皮瓣成活、外观恢复情况。术后6个月评价患者的语音功能、吞咽功能, 满分均为10分, 分数越高代表恢复越好。结果共纳入47例患者, 男27例, 女20例, 年龄43~79岁。其中颊部恶性肿瘤19例, 舌恶性肿瘤19例, 牙龈恶性肿瘤9例;鳞状细胞癌40例, 腺样囊性癌5例, 黏液表皮样癌2例。颌面部缺损面积(54~84) cm^(2), 皮瓣面积(50~81) cm^(2)。手术中17例使用腓骨进行了下颌骨修复重建。47例患者均获6~18个月随访, 平均12个月。患者术后皮瓣均成活良好, 缺损均得到有效修复, 外观满意, 皮瓣供区均良好恢复, 语音及吞咽功能良好。语音功能评分为(8.15±1.35)分, 吞咽功能评分为(7.43±1.19)分。结论游离腓动脉双叶穿支皮瓣修复颌面部恶性肿瘤术后缺损效果满意, 皮瓣美观, 恢复时间短, 同时可以利用腓骨对缺损的骨组织进行修复。且供区隐蔽, 自身创伤小, 具有一定的实用价值。
Objective To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included.They were treated with bilobed free peroneal artery perforator skin flap.After the tumor was removed,the left leg was used as donor site.Based on the defect area of maxillofacial region,a bilobed perforator flap was designed and harvested.After surgery,the survival of the flap,recovery of voice,swallowing function,and flap appearance were evaluated.Speech and swallowing function were scored on a scale of 10.Results A total of 47 patients were included,27 males and 20 females,aged 43-79 years.There were 19 cases of buccal malignant tumors,19 cases of tongue malignant tumors,9 cases of gingival malignant tumors,40 cases of squamous-cell carcinoma,5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma.The area of maxillofacial defects ranges from(54-84)cm^(2),the area of the flap ranges from(50-81)cm^(2).During the operation,17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap.All 47 patients were followed up for an average of 12 months.All patients’postoperative defects were effectively covered,the flaps survived,the appearance was satisfactory,the flap donor area is well restored,and the speech and swallowing functions were good.The scores of speech function and swallowing function were(8.15±1.35)and(7.43±1.19)respectively.Conclusions The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors.The flap appearance is acceptable,the recovery time is short.The defective skeletal tissue can be repaired at the same time.with concealed the donor site.
作者
冯宇杰
朱江
吴森斌
沈小波
刘悦
吴敏棋
李磊
宋冬惠
Feng Yujie;Zhu Jiang;Wu Senbin;Shen Xiaobo;Liu Yue;Wu Minqi;Li Lei;Song Donghui(Department of Plastic Surgery,Sichuan Provincial People’s Hospital&Sichuan Academy of Medical Sciences,Chengdu 610072,China)
出处
《中华整形外科杂志》
CSCD
2022年第11期1254-1257,共4页
Chinese Journal of Plastic Surgery
基金
江苏省六大人才高峰项目(2013-WSW-048)
南通市科技局市级科技计划项目(MSZ18111)。
关键词
外科皮瓣
腓动脉
双叶穿支皮瓣
缺损
修复
Surgical flap
Peroneal artery
Double-leaf perforator flap
Defect,repair
