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游离前臂桡侧皮瓣修复术后鼻咽气道狭窄

FAMM Flap in Reconstructing Postsurgical Nasopharyngeal Airway Stenosis.

作者信息

Nangole Ferdinand Wanjala, Khainga Stanley Ominde

机构信息

Department of Surgery (Plastic), University of Nairobi, Nairobi 00200, Kenya.

出版信息

Plast Surg Int. 2014;2014:276058. doi: 10.1155/2014/276058. Epub 2014 Sep 21.

Abstract

Introduction. Postsurgical nasopharyngeal airway stenosis can be a challenge to manage. The stenosis could be as a result of any surgical procedure in the nasopharyngeal region that heals extensive scarring and fibrosis. Objective. To evaluate patients with nasopharyngeal stenosis managed with FAMM flap. Study Design. Prospective study of patients with nasopharyngeal stenosis at the Kenyatta National Hospital between 2010 and 2013 managed with FAMM flap. Materials and Methods. Patients with severe nasopharyngeal airway stenosis were reviewed and managed with FAMM flaps at the Kenyatta National Hospital. Postoperatively they were assessed for symptomatic improvement in respiratory distress, patency of the nasopharyngeal airway, and donor site morbidity. Results. A total of 8 patients were managed by the authors in a duration of 4 years with nasopharyngeal stenosis. Five patients were managed with unilateral FAMM flaps in a two-staged surgical procedure. Four patients had complete relieve of the airway obstruction with a patent airway created. One patient had a patent airway created though with only mild improvement in airway obstruction. Conclusion. FAMM flap provides an alternative in the management of postsurgical severe nasopharyngeal stenosis. It is a reliable flap that is easy to raise and could provide adequate epithelium for the stenosed pharynx.

摘要

引言。术后鼻咽气道狭窄的处理可能具有挑战性。这种狭窄可能是由于鼻咽区域的任何手术操作导致广泛的瘢痕形成和纤维化所致。目的。评估采用FAMM皮瓣治疗的鼻咽狭窄患者。研究设计。对2010年至2013年在肯雅塔国家医院接受FAMM皮瓣治疗的鼻咽狭窄患者进行前瞻性研究。材料与方法。对肯雅塔国家医院患有严重鼻咽气道狭窄的患者进行评估,并采用FAMM皮瓣进行治疗。术后评估患者呼吸窘迫症状的改善情况、鼻咽气道的通畅情况以及供区并发症。结果。作者在4年时间里共治疗了8例鼻咽狭窄患者。5例患者采用双侧FAMM皮瓣进行两阶段手术治疗。4例患者气道梗阻完全缓解,建立了通畅的气道。1例患者建立了通畅的气道,但气道梗阻仅略有改善。结论。FAMM皮瓣为术后严重鼻咽狭窄的治疗提供了一种选择。它是一种可靠的皮瓣,易于掀起,可为狭窄的咽部提供足够的上皮组织。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbe6/4189985/0bac5ac8c785/PSI2014-276058.001.jpg

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