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用于头颈部重建的胸外侧皮瓣、肌皮瓣和联合皮瓣的手术技术及结果

Surgical techniques and results of lateral thoracic cutaneous, myocutaneous, and conjoint flaps for head and neck reconstruction.

作者信息

Yuen Anthony Po-Wing, Ng Raymond Wai-Man

机构信息

Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR, China.

出版信息

Laryngoscope. 2007 Feb;117(2):288-94. doi: 10.1097/01.mlg.0000250494.62826.6b.

Abstract

BACKGROUND

This paper aims at presentation of our surgical techniques and results of the lateral thoracic (LT) flaps for head and neck reconstructions.

METHOD

There were seven LT cutaneous, seven LT myocutaneous, and two LT conjoint myocutaneous flaps for reconstruction of head and neck mucosal or cutaneous defects.

RESULTS

The largest flap size was 22 cm x 13 cm. All donor sites were closed primarily. The highest point of reconstruction was in the nasopharynx internally and zygoma externally. All flaps survived without major complication.

CONCLUSIONS

The LT flap has the versatility of cutaneous, myocutaneous, and conjoint flaps with pectoralis major or latissimus dorsi myocutaneous flaps to reconstruct large surgical defects. It has a large, reliable surface area, a long pedicle to reach nasopharynx and zygoma, and has less bulky muscle to facilitate tubular reconstruction of circumferential pharyngeal defect, one-stage operation, esthetic hidden donor site scar in axillary region, and minimal donor site morbidity. It is an additional reliable pedicle flap in our armamentarium for reconstruction of both cutaneous and mucosal defects in the head and neck region.

摘要

背景

本文旨在介绍我们使用胸外侧(LT)皮瓣进行头颈部重建的手术技术及结果。

方法

采用7个LT皮瓣、7个LT肌皮瓣和2个LT联合肌皮瓣修复头颈部黏膜或皮肤缺损。

结果

最大皮瓣面积为22 cm×13 cm。所有供区均一期缝合。重建的最高点在内侧为鼻咽部,外侧为颧骨。所有皮瓣均存活,无严重并发症。

结论

LT皮瓣兼具皮瓣、肌皮瓣及联合瓣的多样性,可与胸大肌或背阔肌肌皮瓣一起用于修复大型手术缺损。它具有较大且可靠的表面积、较长的蒂以到达鼻咽部和颧骨,肌肉组织较少便于对环形咽缺损进行管状重建、可一期手术,供区瘢痕位于腋窝区域美观隐蔽,且供区并发症极少。它是我们用于头颈部皮肤和黏膜缺损重建的可靠带蒂皮瓣。

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