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目的 本文报告舌全切除术后下腹直肌肌皮瓣全舌再造的新方法。方法 先行患侧颈清及对侧舌骨上淋巴清扫术 ,保留对侧颌外动、静脉为供区血管。将全舌切除后取一侧下腹直肌肌皮瓣游离微血管吻合移植全舌再造。结果 下腹直肌肌皮瓣有恒定的下腹直肌深动、静脉血管为肌皮瓣之血管蒂 ,该蒂可取长约 4～ 6cm ,血管动脉直径 3 .5～ 5mm ,静脉直径 4～ 6mm ,可与甲状腺上动、静脉 ,颌外动、静脉行端 -端吻合。腹直肌与口底肌肉、皮瓣后端与舌骨、两侧前端与口底粘膜缝合。该肌皮瓣行舌再造后有足够的容积 ,能使患者最大限度地恢复吞咽及语言功能。结论 游离下腹直肌肌皮瓣微血管吻合行舌再造是一个可被推荐的新方法。
Objective This article reports a new method of total tongue reconstruction of the lower rectus abdominis myocutaneous flaps after total tongue resection. Methods The ipsilateral neck and the contralateral suprahylangeal lymph node dissection were performed. The contralateral maxillary external and medial venous vessels were reserved. After the removal of the entire tongue to take one side of the lower rectus abdominis muscle flap free microvascular anastomosis total tongue reconstruction. Results Lower rectus abdominis myocutaneous flap had constant deep rectus abdominis muscle and venous blood vessel pedicled with vascular pedicle. The length of pedicel was about 4 ~ 6cm, diameter of vascular artery was 3.5 ~ 5mm, diameter of vein was 4 ~ 6mm, With the thyroid gland, vein, external jaw movement, venous line end - anastomosis. Rectus abdominis and floor muscles, flaps and hyoid flaps, both sides of the front and mouth mucosal suture. The myocutaneous flap after tongue reconstruction has sufficient volume, enabling patients to maximize the resumption of swallowing and language functions. Conclusion Free rectus abdominis musculocutaneous flap microvascular anastomosis tongue reconstruction is a new method that can be recommended.