Objective To retrospectively review the single team's experience of oral and maxillofacialhead and neck reconstruction involving 41 soft tissue free flap procedures.Methods From 1994 to 2012,41 patients who underw...Objective To retrospectively review the single team's experience of oral and maxillofacialhead and neck reconstruction involving 41 soft tissue free flap procedures.Methods From 1994 to 2012,41 patients who underwent oral and maxillofacial-head and neck soft tissue free flap reconstruction at the Department of Oral and Maxillofacial-Head and Neck Surgical Oncology,Hospital and College of Stomatology,Xi'an Jiaotong University,were reviewed with clinicopathologic data.Results The 41 patients included 24 men and 17 women with a mean age of 54 years.A total of 41 soft tissue free flaps were performed to reconstruct different anatomical structures in the head and neck region including oral mucosa,facial bone,head and neck skin.Two types of soft tissue free flaps were used to reconstruct surgical defects,including radial forearm flap and latissimus dorsi myocutaneous flap.Radial forearm flaps were used for 37cases and latissimus dorsi-myocutaneous flaps were 4 cases.Of 41 cases,39 were successful,with an overall success rate of 95.1%.There were 2 free flap failures,including one radial forearm flap and one latissimus dorsi-myocutaneous flap(partial flap necrosis);hence,the flap success rates for radial forearm flap and latissimus dorsimyocutaneous were,respectively,97.3% and 87.5%.Conclusions Radial forearm flap and latissimus dorsi-myocutaneous flap are reliable soft tissue free flaps to repair oral and maxillofacial-head and neck area with high success rate,which resulted in good functionally and cosmetically with fewer complications both donor and recipient sites.展开更多
目的探讨口腔颌面头颈部恶性肿瘤患者围手术期死亡病例的临床特点。方法回顾1999年1月~2019年12月于上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科治疗并发生围手术期死亡的口腔颌面头颈部恶性肿瘤患者的一般资料、病理诊断以...目的探讨口腔颌面头颈部恶性肿瘤患者围手术期死亡病例的临床特点。方法回顾1999年1月~2019年12月于上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科治疗并发生围手术期死亡的口腔颌面头颈部恶性肿瘤患者的一般资料、病理诊断以及临床治疗信息;围手术期死亡因素分为外科因素、内科因素、复合因素(内科因素联同外科因素)以及个人因素,使用SPSS17.0软件统计分析不同前提下死亡因素组成差异。结果最终纳入55例患者:男性39例,女性16例。12例具有吸烟史,28例患有基础性疾病。20例接受过术前放疗,9例接受过术前化疗。37例病理学诊断为鳞状细胞癌,9例肿瘤位于上颌骨及颅底区域。围手术期死亡4例发生于术前,1例发生于术中,50例发生于术后。死亡主要因素中:外科因素以颈总动脉破裂为主(8例),内科因素以肺部感染为主(6例),复合因素以血肿合并肺部感染为主(4例),个人因素死亡2例。美国麻醉医师协会(American Society of Anesthesiologist,ASA)评分越高的患者,死亡因素中内科因素占比更高(P=0.039)。结论口腔颌面头颈部恶性肿瘤患者围手术期死亡因素组成较为复杂:颈总动脉破裂是最常见、最致命的外科因素,尤其针对术前接受过放疗的患者;肺部感染是最常见内科并发症;ASA评分越高,围手术期死亡内科因素占比越高。展开更多
基金supported by a grant fromXi'an Jiaotong University School of Medicine for Distinguished Young Scholars(KY200901)
文摘Objective To retrospectively review the single team's experience of oral and maxillofacialhead and neck reconstruction involving 41 soft tissue free flap procedures.Methods From 1994 to 2012,41 patients who underwent oral and maxillofacial-head and neck soft tissue free flap reconstruction at the Department of Oral and Maxillofacial-Head and Neck Surgical Oncology,Hospital and College of Stomatology,Xi'an Jiaotong University,were reviewed with clinicopathologic data.Results The 41 patients included 24 men and 17 women with a mean age of 54 years.A total of 41 soft tissue free flaps were performed to reconstruct different anatomical structures in the head and neck region including oral mucosa,facial bone,head and neck skin.Two types of soft tissue free flaps were used to reconstruct surgical defects,including radial forearm flap and latissimus dorsi myocutaneous flap.Radial forearm flaps were used for 37cases and latissimus dorsi-myocutaneous flaps were 4 cases.Of 41 cases,39 were successful,with an overall success rate of 95.1%.There were 2 free flap failures,including one radial forearm flap and one latissimus dorsi-myocutaneous flap(partial flap necrosis);hence,the flap success rates for radial forearm flap and latissimus dorsimyocutaneous were,respectively,97.3% and 87.5%.Conclusions Radial forearm flap and latissimus dorsi-myocutaneous flap are reliable soft tissue free flaps to repair oral and maxillofacial-head and neck area with high success rate,which resulted in good functionally and cosmetically with fewer complications both donor and recipient sites.
文摘目的探讨口腔颌面头颈部恶性肿瘤患者围手术期死亡病例的临床特点。方法回顾1999年1月~2019年12月于上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科治疗并发生围手术期死亡的口腔颌面头颈部恶性肿瘤患者的一般资料、病理诊断以及临床治疗信息;围手术期死亡因素分为外科因素、内科因素、复合因素(内科因素联同外科因素)以及个人因素,使用SPSS17.0软件统计分析不同前提下死亡因素组成差异。结果最终纳入55例患者:男性39例,女性16例。12例具有吸烟史,28例患有基础性疾病。20例接受过术前放疗,9例接受过术前化疗。37例病理学诊断为鳞状细胞癌,9例肿瘤位于上颌骨及颅底区域。围手术期死亡4例发生于术前,1例发生于术中,50例发生于术后。死亡主要因素中:外科因素以颈总动脉破裂为主(8例),内科因素以肺部感染为主(6例),复合因素以血肿合并肺部感染为主(4例),个人因素死亡2例。美国麻醉医师协会(American Society of Anesthesiologist,ASA)评分越高的患者,死亡因素中内科因素占比更高(P=0.039)。结论口腔颌面头颈部恶性肿瘤患者围手术期死亡因素组成较为复杂:颈总动脉破裂是最常见、最致命的外科因素,尤其针对术前接受过放疗的患者;肺部感染是最常见内科并发症;ASA评分越高,围手术期死亡内科因素占比越高。
