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颞肌肌筋膜瓣与面颈胸皮瓣联合修复全层颊部缺损

Reconstruction of full-thickness cheek defects with combined temporalis myofacial and facial-cervico-pectoral flaps.

作者信息

Chen Weiliang, Zeng Shuguang, Li Jingsong, Yang Zhaohui, Huang Zhiquan, Wang Yongjie

机构信息

Department of Oral and Maxillofacial Surgery, the Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jan;103(1):e10-5. doi: 10.1016/j.tripleo.2006.07.009. Epub 2006 Oct 27.

Abstract

OBJECTIVE

The objective of this study was to assess using the temporal myofacial flaps (TMFF) and the facial-cervico-pectoral flap (FCPF) to provide both inner and outer linings for large full-thickness cheek defects following ablative oral cancer surgery.

STUDY DESIGN

Twelve patients with malignant tumors in the buccal region were treated by extensive surgical dissection, and the cheek mucosa defects were repaired with the TMFF and the cheek skin defects were reconstructed with the FCPF. There were 9 male and 3 female patients, age range from 18 to 70 years (mean 52.8). The full-thickness cheek defects ranged from 7 x 6 cm to 10 x 8 cm in size.

RESULTS

No patient had complete loss of flap; 3 patients had minor complications (TMFF and FCPF partial necrosis and FCPF distal dehiscence) all of which settled with conservative management. Mouth opening was normal in 10 patients, and facial contour was satisfactory in 8 patients. The follow-up period varied from 6 to 26 months (mean 15.2); 3 tumors had local recurrences and 2 patients died from tumor metastasis.

CONCLUSION

We found the technique to be anatomically sound, technically easy and reliable, and believe it is a useful method for the reconstruction of large full-thickness cheek defects.

摘要

目的

本研究的目的是评估使用颞肌筋膜瓣(TMFF)和面颈胸皮瓣(FCPF)为口腔癌切除术后的大面积全层颊部缺损提供内层和外层衬里。

研究设计

12例颊部恶性肿瘤患者接受了广泛的手术切除,颊黏膜缺损用颞肌筋膜瓣修复,颊部皮肤缺损用面颈胸皮瓣重建。男性9例,女性3例,年龄18至70岁(平均52.8岁)。全层颊部缺损大小为7×6cm至10×8cm。

结果

无患者皮瓣完全坏死;3例患者出现轻微并发症(颞肌筋膜瓣和面颈胸皮瓣部分坏死以及面颈胸皮瓣远端裂开),均经保守治疗痊愈。10例患者张口正常,8例患者面部轮廓满意。随访时间为6至26个月(平均15.2个月);3例肿瘤局部复发,2例患者死于肿瘤转移。

结论

我们发现该技术在解剖学上合理,技术上简单可靠,认为它是重建大面积全层颊部缺损的一种有用方法。

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