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髂血管腹内斜肌肌瓣修复下颌骨复合性缺损。

Vascular iliac myofascial flap to repair compound defect of the jaw.

机构信息

Department of Oral and Maxillofacial-Head and Neck Oncology, School of Stomatology-Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China.

Department of Oral and Maxillofacial-Head and Neck Oncology, School of Stomatology-Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China.

出版信息

J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):666-671. doi: 10.1016/j.jormas.2022.06.022. Epub 2022 Jun 26.

Abstract

The vascular iliac myofascial flap is a compound flap with the deep circumflex iliac artery (DCIA) as the vascular pedicle, carrying the iliac bone and parts of the internal oblique, external oblique and muscle-fascial tissue that cover the surface of the iliac crest and inside the iliac bone. The aim of this study was to advocate a feasible surgical strategy for maxillofacial surgeons through our review of clinical applications and to improve the quality of life of patients after the operation. In recent years, Stomatology Hospital of Wuhan University has performed dozens of vascularized iliac myofascial flaps, not only to repair jaw defects but also to complete the repair of intraoral soft tissue defects. 20 patients were followed up. These patients with jaw tumors who received a vascular iliac myofascial flap to repair compound defects of the jaw from 2018 to 2020. The Quality of Life Questionnaire-Head and Neck Cancer-37 (QLQ-H&N37) was used to evaluate their speech function (Z=-0.061, P>0.05) and postoperative aesthetics (Z=-2.824, P<0.05). All patients obtained good surgical results and satisfaction in terms of aesthetics and function. The successful reconstruction of these cases prove that the vascularized iliac composite flap with myofascial tissue is a reliable flap for the reconstruction of maxillofacial defects.

摘要

髂血管腹内斜肌筋膜瓣是一种复合瓣,以旋髂深动脉(DCIA)为血管蒂,携带髂骨和部分内斜肌、外斜肌和筋膜组织,覆盖髂嵴表面和髂骨内部。本研究旨在通过对临床应用的回顾,为颌面外科医生倡导一种可行的手术策略,提高术后患者的生活质量。近年来,武汉大学口腔医院已完成数十例带血管髂肌筋膜瓣,不仅用于修复颌骨缺损,还用于完成口腔内软组织缺损的修复。对 20 例颌骨肿瘤患者进行了随访。这些患者在 2018 年至 2020 年间接受了髂血管腹内斜肌筋膜瓣修复颌骨复合缺损,使用头颈部癌症生存质量量表-37 版(QLQ-H&N37)评估了他们的言语功能(Z=-0.061,P>0.05)和术后美学(Z=-2.824,P<0.05)。所有患者在美学和功能方面均获得了良好的手术效果和满意度。这些病例的成功重建证明,带肌筋膜组织的血管化髂骨复合瓣是颌面部缺损重建的可靠皮瓣。

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