Kuo Yur-Ren, Jeng Seng-Feng, Wei Fu-Chan, Su Chih-Ying, Chien Chih-Yen
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Head Neck. 2008 Aug;30(8):1001-6. doi: 10.1002/hed.20807.
Extensive composite defects involving the lip and cheek present difficult reconstructive challenges. This study presents a technique using anterolateral thigh (ALT) flaps with vascularized fascia for large complex oral sphincter defect reconstruction.
Fifteen patients who had undergone oral cancer ablation were enrolled in the study. The average area of intraoral lining and cheek-lip skin defects was 96.9 cm(2). Upper-lip defects ranged 0% to 60%, and lower-lip defects ranged 20% to 80%. Skin and intraoral lining defects were replaced by an ALT fasciacutaneous flap. The vascularized fascia of the flap was used to provide lip suspension.
Flap survival was 100%. All but 1 patient had good static suspension. Nine patients had adequate oral competence without drooling, but 6 had occasional oral incontinence. All patients achieved an acceptable appearance.
For extensive cheek-lip composite defects, ALT flap together with vascularized fascia has proven to be a useful option for functional reconstruction.
涉及唇部和面颊的大面积复合组织缺损带来了重建方面的难题。本研究介绍了一种使用带血管化筋膜的股前外侧(ALT)皮瓣修复大型复杂口腔括约肌缺损的技术。
15例接受口腔癌切除手术的患者纳入本研究。口腔内衬及面颊-唇部皮肤缺损的平均面积为96.9平方厘米。上唇缺损范围为0%至60%,下唇缺损范围为20%至80%。皮肤及口腔内衬缺损采用ALT筋膜皮瓣修复。皮瓣的血管化筋膜用于提供唇部悬吊。
皮瓣存活率为100%。除1例患者外,其余患者均获得良好的静态悬吊效果。9例患者口腔功能良好,无流涎现象,但6例患者偶尔存在口腔失禁。所有患者外观均可接受。
对于大面积面颊-唇部复合缺损,ALT皮瓣联合血管化筋膜已被证明是一种有效的功能重建选择。