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大型恶性肿瘤整块切除术后口咽缺损的主要覆盖(作者译)

[Primary covering of oropharyngeal defects after block resection of large malignant tumors (author's transl)].

作者信息

Weidenbecher M, Gammert C, Thumfart W, Waller G

出版信息

Laryngol Rhinol Otol (Stuttg). 1977 Mar;56(3):249-56.

PMID:140966
Abstract

The covering of defects in ablative oral surgery is associated with particular problems because, in order to avoid the formation of salivary fistulas, a primary closure should be aimed at. Between 1973 and 1975 86 carcinomas of the floor of the mouth, the tongue or the oropharynx were treated by block resection including radical neck dissection without preoperative radiation in 28 Cases the forehead flap and in 20 cases the tongue flap were employed. While the foreheaded flap necessitates the preservation of the ipsilateral A. carotis externa, the tongue flap can be used even if the ipsilateral lingual artery is sacrified. The tongue flap has functional and cosmetic advantages in comparison to the forehead flap. The temporarily transsected mandibula was refixed by compression plates without intermaxillary wiring.

摘要

口腔切除术后缺损的覆盖存在特殊问题,因为为避免形成唾液瘘,应争取一期缝合。1973年至1975年间,86例口底、舌或口咽癌患者接受了包括根治性颈清扫术在内的整块切除术,其中28例未行术前放疗,采用额瓣修复,20例采用舌瓣修复。额瓣修复需保留同侧颈外动脉,而即使牺牲同侧舌动脉也可使用舌瓣。与额瓣相比,舌瓣具有功能和美容方面的优势。临时截断的下颌骨用加压钢板固定,无需颌间结扎。

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