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颈僵患者行头颈部复发性肿瘤切除术后,可利用顺行和逆行颞浅血管作为受区血管进行再重建。

Superficial temporal vessels, both anterograde and retrograde limbs, are viable recipient vessels for recurrent head and neck reconstruction in patients with frozen neck.

机构信息

Department of Otolaryngology, Singapore General Hospital, Singapore.

Department of Plastic and Reconstructive Surgery, E-Da Hospital, Kaohsiung, Taiwan.

出版信息

Head Neck. 2019 Oct;41(10):3618-3623. doi: 10.1002/hed.25886. Epub 2019 Jul 26.

Abstract

BACKGROUND

Reconstruction of recurrent head and neck malignancy especially in the presence of a frozen neck is challenging. The superficial temporal vessels would be ideal as recipient vessels because they lie out of the previous surgical and radiation field.

METHODS

We conducted a retrospective case-control study based on our database between January 2013 and June 2016. A total of 581 primary cases were selected as controls. The 60 test group patients had (a) recurrent head and neck reconstruction, (b) previous surgery and irradiation, (c) frozen neck, and (d) superficial temporal vessels as recipients.

RESULTS

There was no significant difference between vascular compromise rates of superficial temporal vessels (anterograde and retrograde limbs) and controls (P > .05). Flap success rate of the test and control group is comparable, 95% vs 98% respectively.

CONCLUSION

Superficial temporal vessels, both anterograde and retrograde, should be the first consideration for recurrent intraoral, facial, and scalp reconstruction with frozen necks.

摘要

背景

在颈部僵硬的情况下,重建头颈部复发性恶性肿瘤,特别是在存在颈部僵硬的情况下,具有挑战性。由于浅颞血管位于先前的手术和放射治疗区域之外,因此它们是理想的受体血管。

方法

我们基于 2013 年 1 月至 2016 年 6 月的数据库进行了回顾性病例对照研究。共选择了 581 例原发性病例作为对照组。60 例试验组患者具有(a)头颈部复发性重建,(b)先前的手术和放疗,(c)颈部僵硬和(d)浅颞血管作为受体。

结果

浅颞血管(顺行和逆行支)和对照组的血管损伤率无显著差异(P>.05)。试验组和对照组的皮瓣成功率相当,分别为 95%和 98%。

结论

对于颈部僵硬的复发性口腔、面部和头皮重建,浅颞血管(顺行和逆行)应是首选。

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