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用于腭部重建的腭黏膜骨膜岛状瓣

Palatal Mucoperiosteal Island Flaps for Palate Reconstruction.

作者信息

Kim Hong Youl, Hwang Jin, Lee Won Jai, Roh Tai Suk, Lew Dae Hyun, Yun In Sik

机构信息

Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Arch Craniofac Surg. 2014 Aug;15(2):70-74. doi: 10.7181/acfs.2014.15.2.70. Epub 2014 Aug 14.

Abstract

BACKGROUND

Many options are available to cover a palatal defect, including local or free flaps. The objective of this study was to evaluate the usefulness of palatal mucoperiosteal island flap in covering a palatal defect after tumor excision.

METHODS

Between October 2006 and July 2013, we identified 19 patients who underwent palatal reconstruction using a palatal mucoperiosteal island flap after tumor excision. All cases were retrospectively analyzed by defect location, size, tumor pathology, type of reconstruction, and functional outcomes. Speech and swallowing functions were evaluated using a 7-point visual analog scale (VAS) score.

RESULTS

Among the 19 patients, there were 7 men and 12 women with an age range of 25 to 74 years (mean, 52.5±14.3 years). The size of flaps was 2-16 cm (mean, 9.4±4.2 cm). Either unilateral or bilateral palatal island flaps were used depending on the size of defect. During the follow-up period (mean, 32.7±21.4 months), four patients developed a temporary oronasal fistula, which healed without subsequent operative. The donor sites were well re-epithelized. Speech and swallowing function scores were 6.63±0.5 and 6.58±0.69 on the 7-point VAS, indicating the ability to eat solid foods and communicate verbally without significant disability.

CONCLUSION

The palatal mucoperiosteal island flap is a good reconstruction modality for palatal defects if used under appropriate indications. The complication rates and donor site morbidity are low, with good functional outcomes.

摘要

背景

有多种方法可用于修复腭部缺损,包括局部或游离皮瓣。本研究的目的是评估腭部黏骨膜岛状皮瓣在肿瘤切除后修复腭部缺损中的应用价值。

方法

2006年10月至2013年7月期间,我们确定了19例在肿瘤切除后使用腭部黏骨膜岛状皮瓣进行腭部重建的患者。所有病例均根据缺损部位、大小、肿瘤病理、重建类型和功能结果进行回顾性分析。使用7分视觉模拟量表(VAS)评分评估言语和吞咽功能。

结果

19例患者中,男性7例,女性12例,年龄范围为25至74岁(平均52.5±14.3岁)。皮瓣大小为2 - 16厘米(平均9.4±4.2厘米)。根据缺损大小使用单侧或双侧腭岛状皮瓣。在随访期间(平均32.7±21.4个月),4例患者出现暂时性口鼻瘘,未经后续手术自行愈合。供区重新上皮化良好。在7分VAS上,言语和吞咽功能评分分别为6.63±0.5和6.58±0.69,表明能够食用固体食物并进行言语交流,无明显功能障碍。

结论

如果在适当的适应证下使用,腭部黏骨膜岛状皮瓣是修复腭部缺损的一种良好重建方式。并发症发生率和供区发病率低,功能结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dc6/5556817/5127f77758d7/acfs-15-70-g001.jpg

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