Closmann James J, Pogrel M Anthony, Schmidt Brian L
Department of Oral and Maxillofacial Surgery, University of California, San Francisco, CA 94143-0440, USA.
J Oral Maxillofac Surg. 2006 Mar;64(3):367-74. doi: 10.1016/j.joms.2005.11.025.
The aim of this study was to review and describe techniques for the reconstruction of large, complex perioral defects after resection of oral squamous cell carcinoma with emphasis on cosmetic and functional outcome.
A review of techniques and selected case presentations using different flap designs for the reconstruction of large perioral defects following resection of squamous cell carcinoma was performed. The Bernard and Karapandzic flaps were used for large lower lip defects. A Zisser flap technique was used to reconstruct a large commissure defect.
All reconstructed patients had acceptable functional results and healed without complication. The large lower lip defects were easily closed with the Bernard and Karapandzic flaps. The commissure defect was reconstructed using the Zisser technique. While cosmesis was acceptable in all cases, the commissure was the most difficult region to reconstruct with a favorable appearance. There were no flap failures. The Karapandzic flap led to greater rounding of the commissure area and the composite resection resulted in a lack of lower lip support that was improved with prosthesis. Function was noted to be excellent in the Bernard and Karapandzic flaps, with the patients able to purse lips and blow up balloon-type devices.
The Bernard, Karapandzic, and Zisser flaps provide a predictable method to reconstruct large perioral defects following resection for oral cancer. Subsequent fabrication of a prosthesis can aid in lip support for the resected area.
本研究旨在回顾和描述口腔鳞状细胞癌切除术后大型复杂口周缺损的重建技术，重点关注美容和功能效果。
对鳞状细胞癌切除术后使用不同皮瓣设计重建大口周缺损的技术及部分病例进行回顾。Bernard皮瓣和Karapandzic皮瓣用于修复较大的下唇缺损。采用Zisser皮瓣技术修复较大的口角缺损。
所有接受重建的患者功能恢复良好，愈合过程无并发症。Bernard皮瓣和Karapandzic皮瓣能轻松闭合较大的下唇缺损。口角缺损采用Zisser技术进行重建。尽管所有病例的美容效果均可接受，但口角是最难重建出理想外观的区域。未出现皮瓣坏死。Karapandzic皮瓣使口角区域更圆润，复合切除导致下唇支撑不足，使用假体后有所改善。Bernard皮瓣和Karapandzic皮瓣的功能效果极佳，患者能够撅嘴和吹气球类装置。
Bernard皮瓣、Karapandzic皮瓣和Zisser皮瓣为口腔癌切除术后重建大型口周缺损提供了可预测的方法。后续制作假体有助于为切除区域提供唇部支撑。
