Guzu Michel, Rossetti Diego, Hennet Philippe R
Dentistry and Oromaxillofacial Surgery Unit, Department of Surgery, ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, France.
Department of Surgery, CHV ADVETIA, Vélizy-Villacoublay, France.
Front Vet Sci. 2021 May 21;8:685036. doi: 10.3389/fvets.2021.685036. eCollection 2021.
Primary treatment of most oromaxillofacial tumors in dogs and cats is resective surgery. Management of malignant tumors may be very challenging as wide/radical free-margin surgical removal must be achieved while preserving vital functions. Removal of orofacial tumors may result in large defects exposing the oral cavity or creating a communication with the nasal, pharyngeal, or orbital cavities. Such defects require orofacial reconstruction in order to restore respiratory and manducatory functions. The veterinary surgeon must be familiar with reconstructive techniques in order to prevent the inability of closing the defect, which could lead to an insufficient resection. Small oral defects exposing the nasal cavity are best closed with local random mucosal flaps. Closure of large oral defects may be better achieved with a facial or major palatine-based axial-pattern flap. Small to moderate facial defects can be closed with local advancement or transposition skin flaps. Reconstruction of large facial defects often requires the use of locoregional axial pattern flaps such as the caudal auricular, the superficial temporal, or the facial (angularis oris) myocutaneous axial pattern flaps. Recent publications have shown that the facial (angularis oris) flap is a very versatile and reliable flap in orofacial reconstructive surgery. A surgical decision algorithm based on the size, nature, and location of the defect is proposed.
犬猫大多数口腔颌面部肿瘤的主要治疗方法是手术切除。恶性肿瘤的治疗可能极具挑战性，因为必须在保留重要功能的同时实现广泛/根治性切缘无瘤手术切除。口腔颌面部肿瘤切除可能导致大的缺损，使口腔暴露或与鼻腔、咽腔或眼眶形成连通。此类缺损需要进行口腔颌面部重建以恢复呼吸和咀嚼功能。兽医必须熟悉重建技术，以防止无法闭合缺损，这可能导致切除不充分。暴露鼻腔的小口腔缺损最好用局部随意黏膜瓣关闭。较大口腔缺损的关闭可能用面部或基于腭大神经血管束的轴型皮瓣能更好地实现。中小面部缺损可用局部推进或易位皮瓣关闭。大面部缺损的重建通常需要使用局部轴型皮瓣，如耳后、颞浅或面部（口角）肌皮轴型皮瓣。最近的出版物表明，面部（口角）皮瓣在口腔颌面部重建手术中是一种非常通用且可靠的皮瓣。本文提出了一种基于缺损大小、性质和位置的手术决策算法。
