Rigby Matthew H, Taylor S Mark
Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Curr Opin Otolaryngol Head Neck Surg. 2013 Aug;21(4):311-7. doi: 10.1097/MOO.0b013e328362cf94.
This article provides an overview of the principles of soft tissue reconstruction of the oral cavity, and reviews the recent clinical outcomes for described options.
For small defects of the oral cavity, healing by secondary intention and primary closure are both excellent options and may provide functionally superior results. In defects where a split-thickness skin graft is appropriate, acellular dermis may provide results that are at least as good at lower cost. Free flaps, particularly the radial forearm and the anterolateral thigh, have become the mainstays of oral cavity soft tissue reconstruction for larger defects. Recent clinical series suggest that relatively novel regional flaps provide a reasonable alternative to free flap reconstructions for moderate and some large soft tissue defects.
Soft tissue reconstruction of the oral cavity is a complex task with significant functional implications. There are a large number of reconstructive options available. Systematic appraisal of the defect and options allows the reconstructive surgeon to optimize functional potential by choosing the most appropriate reconstructive option.
本文概述口腔软组织重建的原则,并回顾所述方法的近期临床疗效。
对于口腔小缺损,二期愈合和一期缝合都是很好的选择,且可能提供功能上更优的结果。在适合采用断层皮片移植的缺损中,脱细胞真皮可能以更低成本提供至少同样良好的效果。游离皮瓣,尤其是桡侧前臂皮瓣和股前外侧皮瓣,已成为较大缺损口腔软组织重建的主要手段。近期临床系列研究表明,对于中度和一些大型软组织缺损,相对新颖的区域皮瓣为游离皮瓣重建提供了合理的替代方案。
口腔软组织重建是一项具有重大功能意义的复杂任务。有大量的重建选择。对缺损和选择进行系统评估可使重建外科医生通过选择最合适的重建方案来优化功能潜力。