Mann Robert J, O'Brien Andrew L, Adams Nicholas S, Girotto John A, Polley John W
From the *Pediatric Plastic and Craniofacial Surgery, Helen DeVos Children's Hospital; †College of Human Medicine, Michigan State University; and ‡Plastic Surgery Residency, Grand Rapids Medical Education Partners/Michigan State University, Grand Rapids, MI.
Ann Plast Surg. 2017 Aug;79(2):162-165. doi: 10.1097/SAP.0000000000001089.
Oropharyngeal stenosis (OPS) is a rare postoperative complication of adenotonsillectomy that can be a source of considerable patient distress and morbidity. Circumferential scarring of the soft palate and tonsillar pillars leads to narrowing of the oropharyngeal aperture. This case report describes the novel use of bilateral buccal myomucosal flaps for the repair of postoperative OPS in a 20-year-old woman presenting with dysphagia, odynophagia, dyspnea, and intermittent hypernasal speech. Postoperatively, the patient noted immediate improvement of her symptoms. At 1-month follow-up, she noted complete resolution of her symptoms with no dysphagia, nasal regurgitation, speaking difficulty, dyspnea, or gagging. The buccal flaps were well healed and completely intact, maintaining appropriate height of the tonsillar pillars. The buccal myomucosal flap is an effective tool for numerous palatal and oropharyngeal abnormalities and, as described in this case study, is a reliable, safe, and effective technique that can be considered for the reconstruction of postsurgical OPS.
口咽狭窄（OPS）是腺样体扁桃体切除术后一种罕见的并发症，会给患者带来极大痛苦和发病率。软腭和扁桃体柱的环形瘢痕会导致口咽孔径变窄。本病例报告描述了双侧颊肌黏膜瓣在一名20岁女性患者中的创新性应用，该患者因吞咽困难、吞咽疼痛、呼吸困难和间歇性鼻音过重前来就诊，采用双侧颊肌黏膜瓣修复术后口咽狭窄。术后，患者表示症状立即得到改善。在1个月的随访中，她表示症状完全消失，没有吞咽困难、鼻反流、说话困难、呼吸困难或 gagging（此处原文可能有误，推测为“呛咳”之类的意思）。颊瓣愈合良好且完全完整，保持了扁桃体柱的适当高度。颊肌黏膜瓣是治疗多种腭部和口咽异常的有效工具，如本病例研究所述，是一种可靠、安全且有效的技术，可考虑用于术后口咽狭窄的重建。
