Lee Jonathan Y, Alizadeh Kaveh
New York and Valhalla, N.Y. From the Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai; and the Division of Plastic and Reconstructive Surgery, New York Medical College.
Plast Reconstr Surg. 2016 Jan;137(1):240-243. doi: 10.1097/PRS.0000000000001904.
In this series, the authors describe a modification of the facial artery musculomucosal flap for oronasal fistula repair. The spacer facial artery musculomucosal flap technique is characterized by a pedicle inset into the retromolar trigone and palate, obviating a second operative stage. This was performed in 14 patients with a 5.2-cm mean fistula size. Average follow-up was 4.3 years, with one partial flap necrosis but no recurrent oronasal fistula. There was a mean decrease of 18 percent in the distance between the velum and the posterior pharyngeal wall. The spacer facial artery musculomucosal flap provides a single-stage reconstruction of oronasal fistula while lengthening the palate through a pushback mechanism. Although further study of velopharyngeal function is needed, the spacer facial artery musculomucosal flap may be beneficial for patients with a short velum and an oronasal fistula.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在本系列研究中，作者描述了一种用于口鼻瘘修复的面动脉肌黏膜瓣改良术。间隔面动脉肌黏膜瓣技术的特点是将蒂部植入磨牙后三角和腭部，从而避免了二期手术。该手术应用于14例平均瘘口大小为5.2厘米的患者。平均随访4.3年，有1例部分皮瓣坏死，但无复发性口鼻瘘。软腭与咽后壁之间的距离平均减少了18%。间隔面动脉肌黏膜瓣可对口鼻瘘进行一期重建，同时通过后推机制延长腭部。尽管需要进一步研究腭咽功能，但间隔面动脉肌黏膜瓣可能对口唇短和口鼻瘘患者有益。
临床问题/证据级别：治疗性，四级。
