Cai Yong-Cong, Shui Chun-Yan, Li Chao, Sun Rong-Hao, Zhou Yu-Qiu, Liu Wei, Wang Xu, Zeng Dinfen, Jiang Jian, Zhu Guiquan, Wang Wei, Jiang Zhenghua, Tang Zhenqi
Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China.
Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
Gland Surg. 2019 Aug;8(4):354-361. doi: 10.21037/gs.2019.08.01.
The purpose of this study was to investigate the one-stage reconstruction of primary or secondary neoplastic defects in the parotid masseter area.
Fifty-eight cases of soft tissue defects reconstruction caused by tumors in the parotid masseter area from 2014 to 2018 were analyzed. The minimum area of defect was 4 cm × 5 cm, and the maximum area was 12 cm × 12 cm. According to the characteristics of the defect and the condition of the patient, the individualized repair method was adopted. Among them, 40 cases were repaired with adjacent flaps, 6 cases with pectoralis major myocutaneous flaps and 12 cases with free flaps.
All of the 58 flaps survived, 2 of which were recurrent after radiotherapy. The skin flaps healed poorly with the surrounding skin and healed entirely after 2 weeks of dressing change. The patients were followed up for 6 months to 4 years. One patient with parotid carcinoma recurred locally, one with squamous cell carcinoma of parotid gland died of lung metastasis, and one with malignant melanoma died of brain metastasis.
The soft tissue defect in the parotid masseter region caused by the tumor is common. It is necessary to combine the characteristics of the defect and the general situation of the patient clinically. The individualized method of repair and reconstruction can achieve the effect of a radical cure of the tumor and the consideration of local morphology and function.
本研究旨在探讨腮腺咬肌区原发性或继发性肿瘤性缺损的一期修复重建。
分析2014年至2018年58例腮腺咬肌区肿瘤所致软组织缺损的修复情况。缺损最小面积为4 cm×5 cm，最大面积为12 cm×12 cm。根据缺损特点及患者情况，采用个体化修复方法。其中，40例采用邻位皮瓣修复，6例采用胸大肌肌皮瓣修复，12例采用游离皮瓣修复。
58块皮瓣全部成活，其中2块放疗后复发。皮瓣与周围皮肤愈合欠佳，换药2周后完全愈合。患者随访6个月至4年。1例腮腺癌患者局部复发，1例腮腺鳞状细胞癌患者死于肺转移，1例恶性黑色素瘤患者死于脑转移。
肿瘤所致腮腺咬肌区软组织缺损较为常见。临床上需结合缺损特点及患者全身情况，采用个体化修复重建方法，可达到肿瘤根治及兼顾局部形态和功能的效果。
