Kyoto University Graduate School of Medicine, Department of Otolaryngology - Head & Neck Surgery, Kyoto, Japan.
Japanese Red Cross Wakayama Medical Center, Department of Otolaryngology, Wakayama, Japan.
Auris Nasus Larynx. 2023 Apr;50(2):266-271. doi: 10.1016/j.anl.2022.06.003. Epub 2022 Jun 28.
This study aimed to describe the technique and clinical outcomes of using a palatal mucoperiosteal flap for oro-nasal fistula closure following resection of maxillary sinus cancer.
The study was conducted with the permission of the internal review board of the Japanese Red Cross Wakayama Medical Center. Five consecutive cases from 2016 to 2020 of surgically treated maxillary sinus cancer in which the oro-nasal fistulas were closed using a palatal mucoperiosteal flap were retrospectively reviewed.
Following tumor resection, the oro-nasal fistula was closed using a palatal mucoperiosteal flap. Complete separation of the oral and nasal cavities was achieved in four patients. Oral intake was resumed within two weeks in four patients. All the patients were able to eat foods similar to those in the preoperative period. Their postoperative speech function was excellent, with no difficulty in communicating with others.
In the selected cases of maxillary sinus cancer, preservation of the palatal mucosa and closure of an oro-nasal fistula using a palatal mucoperiosteal flap was possible with reasonable outcomes for swallowing and speech functions. The use of this local flap is recommended as a minimally invasive procedure that can be performed especially in patients with limited physiological reserves which preclude free flap reconstruction.
本研究旨在描述使用腭黏骨膜瓣关闭上颌窦癌切除术后口鼻腔瘘的技术和临床结果。
本研究经日本红十字会和歌山医疗中心内部审查委员会批准。回顾性分析了 2016 年至 2020 年连续 5 例接受手术治疗的上颌窦癌患者的病例资料，这些患者的口鼻腔瘘均使用腭黏骨膜瓣关闭。
在肿瘤切除后，使用腭黏骨膜瓣关闭口鼻腔瘘。4 例患者完全分隔口腔和鼻腔。4 例患者在 2 周内恢复经口进食。所有患者均能进食与术前相似的食物。他们的术后言语功能良好，与他人交流无障碍。
在选择的上颌窦癌病例中，使用腭黏骨膜瓣保留腭黏膜并关闭口鼻腔瘘，可以获得合理的吞咽和言语功能。对于那些生理储备有限、无法进行游离皮瓣重建的患者，这种局部皮瓣的使用是一种微创的推荐方法。
