Moore Brian A, Magdy Emad, Netterville James L, Burkey Brian B
Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, Tennessee, USA.
Laryngoscope. 2003 Jun;113(6):946-51. doi: 10.1097/00005537-200306000-00007.
OBJECTIVES/HYPOTHESIS: The management of palatal defects resulting from the extirpation of benign and malignant lesions uses a variety of methods, with the optimal techniques allowing maximal postoperative function with minimal morbidity. The palatal island flap is an effective, reliable technique for reconstructing postablative oral cavity defects.
All patients who underwent palatal resections for benign or malignant lesions at a tertiary care, referral-based head and neck cancer center since 1995 were eligible. Ten patients were identified whose surgical defects were reconstructed with palatal island flaps. The cases were reviewed for the symptomatology, tumor features, defect size, perioperative and postoperative management, complications, and impact on palatal function.
Ten patients ranging in age from 18 to 81 years underwent palatal island mucoperiosteal flaps after resection of a variety of benign and malignant tumors, most arising from minor salivary glands. The defects ranged in size from 5 to 15 cm2, with extension into the floor of the nose in four cases and to the skull base in two. Nine patients were discharged on a regimen of oral diet, and no patient manifested permanent velopharyngeal insufficiency, speech impairment, or airway compromise. Follow-up ranged from 3 months to 6 years, with an average follow-up of 18.5 months. Delayed donor site re-epithelialization required debridement in one case, and two patients required obturation of small oronasal fistulae.
The palatal island mucoperiosteal flap provides an effective means of reconstructing hard and soft palate defects with few complications and low morbidity.
目的/假设：良性和恶性病变切除术后腭部缺损的处理方法多样，最佳技术应能在术后功能最大化的同时使发病率降至最低。腭岛状皮瓣是一种有效、可靠的口腔缺损修复技术。
选取自1995年以来在一家三级转诊头颈癌中心接受腭部良性或恶性病变切除术的所有患者。确定其中10例患者的手术缺损采用腭岛状皮瓣修复。对这些病例的症状、肿瘤特征、缺损大小、围手术期和术后处理、并发症以及对腭部功能的影响进行回顾。
10例年龄在18至81岁之间的患者在切除各种良性和恶性肿瘤后接受了腭岛状粘骨膜瓣修复，大多数肿瘤起源于小唾液腺。缺损面积为5至15平方厘米，4例延伸至鼻底，2例延伸至颅底。9例患者出院后采用经口饮食方案，无患者出现永久性腭咽闭合不全、言语障碍或气道受损。随访时间为3个月至6年，平均随访时间为18.5个月。1例患者供区延迟上皮化需要清创，2例患者需要封闭小的口鼻瘘。
腭岛状粘骨膜瓣为硬腭和软腭缺损的修复提供了一种有效的方法，并发症少，发病率低。
