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目的:评价延长锁骨上岛状筋膜皮瓣联合延长垂直下斜方肌岛状肌皮瓣修复晚期口腔癌术后颊部大范围洞穿性缺损的可行性。方法:对我院2008年6月—2012年2月施行的17例延长锁骨上岛状筋膜皮瓣联合延长垂直下斜方肌岛状肌皮瓣修复晚期口腔癌切除后颊部黏膜和皮肤巨大洞穿性缺损病例进行回顾分析。结果:17例患者均伴晚期口腔癌切除后的颊部软硬组织巨大洞穿性缺损,修复口腔衬里的延长锁骨上岛状筋膜皮瓣大小为10 cm×8 cm～14 cm×10 cm,修复外部缺损的延长垂直下斜方肌岛状肌皮瓣大小为15 cm×8 cm～25 cm×10 cm。所有病例均无严重并发症,随访6～34个月,9例患者无瘤生存,2例带瘤生存,6例死于局部复发及远处转移。结论:应用延长锁骨上岛状筋膜皮瓣复合延长垂直下斜方肌岛状肌皮瓣修复晚期口腔癌术后颊部大范围洞穿性缺损是一种可靠的修复方法,对于再次手术,以及放疗后病例,在一定程度上优于游离皮瓣等其他修复方法。
OBJECTIVE: To evaluate the feasibility of extending the supraclavicular island fasciocutaneous flap and prolongation of the trapezius myocutaneousis flap in the treatment of large-scale cheek penetrating defects in patients with advanced oral cancer. Methods: From June 2008 to February 2012 in our hospital, 17 cases of extended supraclavicular island fasciocutaneous flap combined with prolonged vertical trapezius myocutaneous flap were used to repair cheek mucosa and skin after advanced oral cancer resection Retrospective analysis of huge cases of penetrating defects. Results: All the 17 patients had huge holes and holes in the buccal soft tissue after resection of the advanced oral cancer. The length of the repaired flap on the supraclavicular island fascia was 10 cm × 8 cm ~ 14 cm × 10 cm, The length of the trapezius myocutaneous flap extending perpendicular to the defect is 15 cm × 8 cm ~ 25 cm × 10 cm. No serious complications were observed in all cases. After 6 to 34 months of follow-up, 9 patients survived without tumor, 2 patients with tumor survived, and 6 patients died of local recurrence and distant metastasis. CONCLUSIONS: The application of prolonged supraclavicular island fasciocutaneous flap to extend the vertical lower trapezius myocutaneous flap for the repair of large-scale cheek defect after advanced oral cancer is a reliable method for reoperation and After radiotherapy cases, to some extent, better than the free flap and other repair methods.