Luo Shihong, Xiao Jingang, Sun Libo, Zhang Li, Zeng Liangnan, Xia Delin, Zhou Hangyu, Zhang Lei
Hua Xi Kou Qiang Yi Xue Za Zhi. 2015 Aug;33(4):409-13. doi: 10.7518/hxkq.2015.04.018.
The aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.
Sixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.
The position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.
CTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor
本研究旨在探讨游离股前外侧肌皮瓣(ALTMF)及计算机断层血管造影(CTA)在中晚期口底癌切除术后口底缺损修复中的应用价值。
16例中晚期口底癌患者行根治性切除,采用ALTMF修复口底及舌缺损。应用CTA规划旋股外侧动脉(LCFA)及其穿支血管,并在术中进行验证。
术中穿支血管位置与术前CTA设计完全一致。16块皮瓣全部成活。所有病例外观及功能均满意。所有供区均一期缝合愈合,无功能障碍。随访6~36个月,除1例(T4N2M0)术后10个月死于转移癌外,15例患者口底及舌重建后外观及功能良好。
CTA能准确显示LCFA及动脉穿支。术前应用CTA规划ALTMF移植穿支是一种可靠、有效的方法,可确保手术安全,效果满意。ALTMF是中晚期口底癌切除术后软组织缺损修复的理想选择。