Zhang Huankang, Zhang Ming, Jiang Xiaowen, Xue Kai, Sun Xicai, Liu Quan, Gu Ye, Li Wanpeng, Song Xiaole, Yu Hongmeng
Department of Otolaryngology,Eye & ENT Hospital,Fudan University,Shanghai,200031,China.
Department of Otolaryngology,Huazhong University of Science and Technology Union Shenzhen Hospital(Nanshan Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jul;36(7):506-509;514. doi: 10.13201/j.issn.2096-7993.2022.07.005.
To explore the anatomy and clinical application of submental flap in the nasopharyngectomy for nasopharyngeal carcinoma. The anatomical study of the submental flap was carried out on 5 cadavers, focusing on exploring the channel of the submental flap transposition to the nasopharyngeal skull base area, and analyzing the nasopharyngeal skull base area covered by the submental flap. A retrospective analysis of 4 patients with submental flap repairment after nasopharyngectomy was performed, and the surgical methods and techniques of submental flap to repair nasopharyngeal nasal skull base defect were introduced in detail. Rusults: It showed that the submental flap could be transposed into the nasopharyngeal skull base through the posteromedial of the mandible-posterior pterygoid muscle-parapharyngeal space channel, and could cover the paraclival internal carotid artery. Clinical practice showed that the submental flap was successfully used to repair the nasopharyngeal skull base defect in 4 patients, and the submental flap grew well in the follow-up. The submental flap is suitable for the repair of the nasopharyngeal skull base defect after nasopharyngeal carcinoma surgery, and it is worthy of clinical promotion.
探讨颏下皮瓣在鼻咽癌鼻咽切除术中的解剖学特点及临床应用。对5具尸体进行颏下皮瓣的解剖学研究,重点探索颏下皮瓣转移至鼻咽颅底区域的通道,并分析颏下皮瓣所覆盖的鼻咽颅底区域。对4例行鼻咽切除术后颏下皮瓣修复的患者进行回顾性分析,详细介绍颏下皮瓣修复鼻咽鼻颅底缺损的手术方法及技巧。结果:结果显示,颏下皮瓣可通过下颌骨后内侧-翼内肌-咽旁间隙通道转移至鼻咽颅底,且可覆盖斜坡旁颈内动脉。临床实践表明,4例患者颏下皮瓣成功用于修复鼻咽颅底缺损,随访中颏下皮瓣生长良好。颏下皮瓣适用于鼻咽癌术后鼻咽颅底缺损的修复,值得临床推广。