Aslan Ismet, Süoğlu Yusufhan, Başaran Bora, Hafız Günter
Department of Otolaryngology, Medicine Faculty of Istanbul University, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2010 Sep-Oct;20(5):226-31.
To compare and contrast the use of the latissimus dorsi myocutaneous flap in complex head and neck defects requiring major reconstructive surgery with respect to the other reconstruction techniques, and to emphasize the importance of this flap as an life and surgeon-saving reconstruction modality.
In this study, 20 cases (17 males, 3 females; mean age 58.5 years; range 48 to 72 years) of major head and neck operations reconstructed with a latissimus dorsi myocutaneous flap in Istanbul University, Istanbul Medical Faculty, Ear, Nose and Throat Clinic between October 2004 and November 2006 were retrospectively examined. The latissimus dorsi myocutaneous flap was preferred as a primary reconstructive modality in eight of the cases and a secondary reconstructive modality in the remaining 12 cases. The reasons for choosing the latissimus dorsi myocutaneous flap as the reconstructive modality were examined in this study and compared with other reconstruction techniques.
Partial flap necrosis was observed in four of the 20 cases. In two of these unsuccessful cases, minor intervention was sufficient to achieve functionally satisfactory results. However, one case with partial flap necrosis was lost due to the uncontrollable primary disease. In the one remaining case who had undergone cranioplasty, partial necrosis of the flap developed after the completion of radiotherapy in the 4th postoperative month. No total flap necrosis was encountered in any of the cases.
The latissimus dorsi myocutaneous flap is a reconstructive modality with a high success rate and should be considered among reconstruction alternatives.
比较和对比背阔肌肌皮瓣在需要进行大型重建手术的复杂头颈部缺损修复中与其他重建技术的应用情况，并强调该皮瓣作为一种挽救生命和医生的重建方式的重要性。
本研究回顾性分析了2004年10月至2006年11月间在伊斯坦布尔大学伊斯坦布尔医学院耳鼻喉科诊所，采用背阔肌肌皮瓣进行头颈部大型手术重建的20例患者（17例男性，3例女性；平均年龄58.5岁；年龄范围48至72岁）。其中8例患者将背阔肌肌皮瓣作为一期重建方式，其余12例作为二期重建方式。本研究探讨了选择背阔肌肌皮瓣作为重建方式的原因，并与其他重建技术进行了比较。
20例患者中有4例出现皮瓣部分坏死。在这4例手术失败的患者中，2例只需进行小手术干预就能获得功能上令人满意的结果。然而，1例皮瓣部分坏死的患者因原发性疾病无法控制而死亡。在剩下1例接受颅骨成形术的患者中，术后第4个月放疗结束后皮瓣出现部分坏死。所有病例均未出现皮瓣完全坏死。
背阔肌肌皮瓣是一种成功率较高的重建方式，应被纳入重建选择之中。
