Head & Neck Unit, Oxford University Hospitals NHS Trust, Oxford, UK.
J Plast Reconstr Aesthet Surg. 2013 Oct;66(10):1365-8. doi: 10.1016/j.bjps.2013.05.029. Epub 2013 Jun 10.
The buccinator musculo-mucosal island or Zhao flap can be used to reconstruct a wide range of intra-oral defects including floor of mouth, tonsillar fossa and lateral tongue. We describe our experience with the inferiorly based facial artery buccinator musculo-mucosal flap for a novel use in the reconstruction of oropharyngeal tumours at the tongue base and lateral pharyngeal wall. We prospectively reviewed all patients who underwent buccinator musculo-mucosal island flap reconstruction examining indication, operative details, and post-operative outcomes. We describe our technique for its novel use in lateral pharynx/tongue base reconstruction through neck dissection access. Deeper flaps were adequately visualised and monitored using flexible nasoendoscopy. There were no flap failures with all patients achieving primary healing with minimal complications. All donor sites closed directly with minimal scarring. Two patients reported mild tightness on mouth opening and two patients reported transient weakness of the mandibular branch of the facial nerve. In our experience the buccinator musculo-mucosal island flap is an extremely versatile 'like for like' local flap option due to its long arc of rotation. As inset can be achieved via neck dissection access, this avoids lip/jaw split as per conventional oropharyngeal surgical management further minimising morbidity. We present the first series of its effective use in oropharyngeal reconstruction.
颊肌黏膜岛皮瓣或赵瓣可用于重建广泛的口腔内缺损，包括口底、扁桃体窝和舌侧。我们描述了我们使用以面动脉为基础的颊肌黏膜岛皮瓣的经验，该皮瓣用于重建舌根和侧咽壁的口咽肿瘤。我们前瞻性地回顾了所有接受颊肌黏膜岛皮瓣重建的患者，检查了适应证、手术细节和术后结果。我们描述了通过颈部解剖进入来将其用于侧咽/舌根部重建的新技术。使用灵活的鼻内镜可以充分观察和监测较深的皮瓣。没有皮瓣失败，所有患者均实现了原发性愈合，并发症最小。所有供区均直接闭合，瘢痕最小。两名患者报告张口轻度紧绷，两名患者报告面神经下颌支短暂无力。根据我们的经验，颊肌黏膜岛皮瓣是一种极其通用的“相似”局部皮瓣选择，因为它具有长的旋转弧。由于可以通过颈部解剖进入来进行插入，因此避免了唇/颌分裂，如传统的口咽手术管理进一步最小化了发病率。我们提出了其在口咽重建中有效使用的第一个系列。
