肌腱悬吊联合前臂皮瓣重建口腔癌术后合并口角缺损的临床应用研究
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摘要
目的:探讨肌腱悬吊联合前臂皮瓣游离移植修复重建口腔癌术后合并口角缺损的临床效果。方法:对12例颊粘膜鳞癌根治术后合并口角缺损的患者,根据唇、颊部和口角缺损大小个性化设计前臂皮瓣,供、受区血管行端端吻合,按缺损长度切取掌长肌肌腱与口轮匝肌和颊肌悬吊缝合重建口角。结果:12例血管化游离移植前臂皮瓣全部存活,术后口角外形满意。术后随访6～24个月,所有患者唇颊部形态、功能恢复良好,无明显言语及咀嚼功能障碍,未见肿瘤复发及远处转移。结论:肌腱悬吊联合前臂皮瓣游离移植是修复口腔癌术后合并口角缺损较为理想的一种选择。
引文
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[2]温磊,王望舒,高海,等.下唇Abbe皮瓣联合面颊部风筝推进皮瓣修复大面积上唇缺损[J].中国修复重建外科杂志,2019,33(4)∶1-3.
[3]尚伟,郑家伟.口腔及口咽癌新版TNM分期与NCCN诊治指南部分解读[J].中国口腔颌面外科杂志,2018,16(6)∶533-546.
[4]张陈平.舌癌的间室外科[J].中国癌症杂志,2013,23(12)∶937-941.
[5]明华伟,何芸,张兴安,等.CTA辅助游离股前外侧肌皮瓣修复舌癌术后缺损的应用研究[J].中国美容医学,2019,28(2)∶23-26.
[6]宋晓萌,陈洁,丁旭,等.微血管吻合器在皮瓣修复颌面缺损的应用体会[J].实用口腔医学杂志,2018,34(1)∶53-56.
[7]胡广伟,王鸿,王涛,等.血管吻合器在游离组织瓣修复颌面缺损中的应用[J].中国美容医学,2018,27(6)∶119-122.
[8]Larrabee YC,Moyer JS.Reconstruction of Mohs defects of the lips and chin[J].Facial Plast Surg Clin North Am,2017,25(3)∶427-442.
[9]Tan O,Kuduban SD,Algan S,et al.Total lower lip reconstruction using free neurotendinofasciocutaneous anterolateral thigh composite flap:a case report[J].J Reconstr Microsurg,2013,29(7)∶487-490.
[10]Krunic AL,Weitzul S,Taylor RS.Advanced reconstructive techniques for the lip and perioral area[J].Dermatol Clin,2005,23(1)∶43-53.
[11]邓铁红,王科,蔡永聪,等.股前外侧穿支皮瓣在头颈肿瘤外科应用中的研究进展[J].肿瘤预防与治疗,2016,29(2)∶97-101.
[12]Cass ND,Terella AM.Reconstruction of the cheek[J].Facial Plast Surg Clin North Am,2019 Feb;27(1)∶55-66.
[13]Gabrysz-Forget F,Tabet P,Rahal A,et al.Free versus pedicled flaps for reconstruction of head and neck cancer defects:a systematic review[J].J Otolaryngol Head Neck Surg,2019,48(1)∶13.
[14]王曦,童国勇,戈春城.股前外侧皮瓣与胸大肌皮瓣在半舌切除术后舌功能性重建中的应用比较[J].临床口腔医学杂志,2018,34(12)∶732-736.
[15]Schneider DS,Wu V,Wax MK.Indications for pedicled pectoralis major flap in a free tissue transfer practice[J].Head Neck,2012,34(8)∶1106-1110.
[16]吴迪,廖烈强,刘志民,等.应用折叠型游离股前外侧皮瓣修复面颊贯通性缺损12例[J].现代肿瘤医学,2017,25(1)∶41-44.
[17]Tang X,Zhang CY,Chen R,et al.Treatment of adenoid cystic carcinoma of the mobile tongue with anterolateral thigh flap reconstruction:A case report[J].Medicine,2019,98(16)∶e15250.
[18]朱伟莉,陈一铭,郁玺玺,等.口腔颌面肿瘤性缺损股前外侧皮瓣修复的并发症危险因素分析及其对护理的启示[J].肿瘤预防与治疗,2019,32(3)∶265-270.
[19]刘小俊,王志学,苏建东,等.股前外侧薄皮瓣在修复重建外科的应用进展[J].中国临床解剖学杂志,2019,37(1)∶110-112.
[20]吴双江,夏德林,明华伟,等.修薄的股前外侧皮瓣修复颊癌术后缺损[J].中华整形外科杂志,2016,32(5)∶339-342.
[21]饶鹏程,罗世洪,王雷,等.CT血管造影辅助设计的个性化股前外侧皮瓣在修复舌癌术后缺损中的应用[J].实用口腔医学杂志,2017,33(5)∶625-629.