Zhong Q, Huang Z G, Fang J G, Chen X J, Chen X H, Hou L Z, Li P D, Ma H Z, He S Z
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University; Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100710, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Sep 7;51(9):671-674. doi: 10.3760/cma.j.issn.1673-0860.2016.09.007.
To evaluate the outcome of one-stage reconstruction of maxillary and orbital defects with modified temporalis muscle flap (TMF) following the removal of malignant neoplasms. In this retrospective study, 15 patients underwent the reconstruction of defects of orbital floor and palate after maxillectomy for malignant tumor were included from June 2008 to June 2014. The modified temporalis muscle flap was used to repair the defects after surgery, and functional outcomes were analyzed. All the patients were followed up for 12-81 months. Three cases of them received preoperative radiotherapy and 12 cases underwent postoperative radiotherapy. All flaps were survived. Epithelization of the tissues in oral and nasal cavity was completed in 4-6 weeks. Good functional reconstruction on swallowing and speaking functional results were achieved with maxillary and orbital reconstruction and no secondary deformity of external nose was observed. The eye positions in all cases were normal. Diplopia, diminution and loss of vision were not found. The modified TMF can be used for simultaneous reconstruction for the defects of orbital floor and palate after maxillectomy in patients whom free tissue flap can not be applied to, showing better cosmetic and functional results.
评估采用改良颞肌瓣（TMF）对恶性肿瘤切除术后上颌骨及眶部缺损进行一期重建的效果。在这项回顾性研究中，纳入了2008年6月至2014年6月期间15例行上颌骨切除术治疗恶性肿瘤后眶底和腭部缺损重建的患者。术后采用改良颞肌瓣修复缺损，并分析功能结果。所有患者均随访12 - 81个月。其中3例患者接受了术前放疗，12例患者接受了术后放疗。所有皮瓣均存活。口腔和鼻腔组织在4 - 6周内完成上皮化。上颌骨和眶部重建后吞咽和说话功能得到良好的功能重建，未观察到外鼻继发畸形。所有病例的眼球位置均正常。未发现复视、视力减退和丧失。改良颞肌瓣可用于无法应用游离组织瓣的患者上颌骨切除术后眶底和腭部缺损的同期重建，具有较好的美容和功能效果。
