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多叶股前外侧嵌合皮瓣用于头颈部复杂缺损的重建

Multipaddled anterolateral thigh chimeric flap for reconstruction of complex defects in head and neck.

作者信息

Jiang Canhua, Guo Feng, Li Ning, Liu Wen, Su Tong, Chen Xinqun, Zheng Lian, Jian Xinchun

机构信息

Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

PLoS One. 2014 Sep 2;9(9):e106326. doi: 10.1371/journal.pone.0106326. eCollection 2014.

DOI:10.1371/journal.pone.0106326
PMID:25180680
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4152256/
Abstract

The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14-23) cm and the mean width was 4.9 (range: 2.5-7) cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck.

摘要

几十年来，股前外侧皮瓣一直是用于覆盖头颈部软组织缺损的常用皮瓣。然而，采用多叶股前外侧嵌合皮瓣修复头颈部多发、复杂的软组织缺损，对重建手术来说仍是一项挑战。本文报道了一组12例临床病例，采用多叶股前外侧嵌合皮瓣修复头颈部多个不同解剖部位的复杂软组织缺损。12例患者中，7例牙关紧闭，诊断为晚期颊癌伴口腔黏膜下纤维化；2例舌癌伴有多处口腔黏膜病变或颊癌；3例下咽癌侵犯颈前皮肤。所有软组织缺损均采用多叶股前外侧嵌合皮瓣修复，其中三叶股前外侧皮瓣9例，双叶皮瓣3例。皮瓣平均长度为19.2（范围：14 - 23）cm，平均宽度为4.9（范围：2.5 - 7）cm。所有皮瓣均存活，供区均一期缝合。平均随访9.1个月后，供区和受区均未出现问题。本研究表明，多叶股前外侧嵌合皮瓣是修复头颈部复杂多发软组织缺损的一种可靠且良好的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f98/4152256/83f75a1efc66/pone.0106326.g015.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f98/4152256/b265adae63eb/pone.0106326.g004.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f98/4152256/83f75a1efc66/pone.0106326.g015.jpg

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