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目的:组织瓣修复缺损是头颈部肿瘤切除术中的重要手段和必要环节。本研究总结65例颊癌和口咽癌不同范围组织缺损用局部带蒂组织瓣的修复方法。方法:回顾2001～2009年我科65例口腔颊癌及口咽癌切除术后选择腭瓣、颏下瓣、面动脉逆行皮瓣、颊脂垫颊肌复合瓣修复颊部及口咽部组织缺损,病变范围和治疗结果。结果:65例皮瓣中,17例腭瓣全部成活,29例颏下瓣26例全部成活,2例部分坏死,1例表层皮肤坏死,7例面动脉逆行皮瓣6例全部成活,1例坏死,12例颊脂垫或颊脂垫颊肌复合瓣全部成活11例,1例部分坏死,总成活率96.9%。31例患者术后有不同程度的张口受限,咀嚼和吞咽功能基本正常。结论:根据颊癌和口咽癌的病变范围决定采用不同的临近带蒂组织瓣修复缺损,修复效果确切,可以明显减少手术创伤和术后并发症,尤其适用于年老及较多基础疾病患者,仍应作为头颈部肿瘤术后缺损修复的重要方法。
OBJECTIVE: Tissue flap repair of defects is an important means and an essential link in tumor resection of head and neck. This study summarized 65 cases of cheek cancer and oropharyngeal carcinoma in different regions of tissue defect with pedicle flap tissue repair method. Methods: From 2001 to 2009, 65 cases of cheek and oropharyngeal tissues were selected from 65 cases of cheek buccal carcinoma and oropharyngeal carcinoma after resection. The flap of the palate, the submental flap, the facial artery retrograde flap and the buccal fat pad buccal muscle flap Defect, extent of lesion and treatment outcome. Results: Of the 65 cases, all the 17 palatal flap survived, and 29 of the 29 submental flaps survived, 2 were partially necrotic, 1 had superficial dermal necrosis, and 6 of 7 had reverse facial flap survived. One case Necrosis, 12 buccal fat pad or buccal fat pad cheek muscle composite flap all survived in 11 cases, 1 case of partial necrosis, the total survival rate of 96.9%. 31 patients had different degrees of postoperative mouth limitation, chewing and swallowing function was normal. Conclusion: According to the extent of lesion of buccal carcinoma and oropharyngeal carcinoma, it is decided to adopt different adjacent pedicle flap to repair the defect. The exact repair effect can obviously reduce the surgical trauma and postoperative complications, especially for elderly patients with more underlying diseases , Should still be used as an important method of head and neck cancer repair of defects.