Rossmiller Sarah R, Ghanem Tamer A, Gross Neil D, Wax Mark K
Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Head Neck. 2009 Sep;31(9):1215-9. doi: 10.1002/hed.21083.
Reconstruction following total laryngopharyngectomy and total glossectomy is quite challenging. Many free flaps are not options for reconstruction of this particular defect because of the large area that requires reconstruction and the size discrepancies of the oral and esophageal stomas. We propose a modified ileocolic free flap for reconstruction of these defects.
We conducted a retrospective chart review.
Two patients underwent a modified ileocolic free flap following total laryngopharyngectomy and total glossectomy. One of these patients was able to tolerate thin liquids by mouth, and 1 patient developed severe trismus limiting oral intake. There were no significant flap-related complications aside from fistula in 3 patients that healed with conservative management.
The modified ileocolic free flap is a viable option for reconstruction following total laryngopharyngectomy and total glossectomy.
全喉咽切除术和全舌切除术后的重建颇具挑战性。由于需要重建的面积较大以及口腔和食管造口的尺寸差异,许多游离皮瓣并非重建这种特殊缺损的选择。我们提出一种改良的回结肠游离皮瓣用于这些缺损的重建。
我们进行了一项回顾性病历审查。
两名患者在全喉咽切除术和全舌切除术后接受了改良的回结肠游离皮瓣手术。其中一名患者能够经口耐受稀流质,另一名患者出现严重牙关紧闭限制了经口摄入量。除3例患者发生瘘且经保守治疗愈合外,未出现与皮瓣相关的严重并发症。
改良的回结肠游离皮瓣是全喉咽切除术和全舌切除术后重建的一种可行选择。