Gao K L, Zhang H, Xie Z H, Zhang J Y, Fan R H, Wang F J, Xie S M, Zhao S P, Jiang W H
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Otorhinolaryngology Major Disease Research Key Laboratory of Hunan Province, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Anatomy Laboratory of Division of Nose and Cranial Base, Clinical Anatomy Center of Xiangya Hospital, Central South University, Changsha 410008, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Nov 7;57(11):1288-1293. doi: 10.3760/cma.j.cn115330-20211206-00774.
To summarize and popularize the application of temporalis muscle flap in repair and reconstruction after the resection of tumor or necrotic foci following radiotherapy of nasopharyngeal carcinoma (NPC). A retrospective analysis was made on the patients treated in the Department of Otorhinolaryngology Head and Neck Surgery of Xiangya Hospital between January 2019 and March 2021 who underwent surgical resection of tumor or necrosis of NPC after radiotherapy and temporalis muscle flap repair. The effect of the repair and the patients' postoperative conditions were analyzed. A total 29 patients, 19 males and 10 females, aged from 33 to 65 years old, were included in the study, and were followed up for 6-35 months. Except for 2 patients who were not followed due to bleeding or special bacterial infection, the others' temporalis muscle flap healed well and no cerebrospinal fluid rhinorrhea or massive hemorrhage occurred. After the operation, all patients had no nasopharyngeal reflux or new open rhinolalia, and in some patients, the open rhinolalia even got relieved. Except for one case of depressed temporal fossa caused by infection and followed debridement and another one case of shallowed forehead wrinkles, the appearances of the other patients were basically symmetrical. Some patients had temporary mouth opening limitation after operation, and all of them recovered after rehabilitation exercises. The temporalis muscle flap can protect the skull base and internal carotid artery, and improve the quality of life of patients after the resection of NPC or necrotic foci. It is a reliable pedicled flap for repairing skull base defect with simple operation procedures and relatively few complications.
总结并推广颞肌瓣在鼻咽癌（NPC）放疗后肿瘤或坏死灶切除修复重建中的应用。对2019年1月至2021年3月在湘雅医院耳鼻咽喉头颈外科接受放疗后NPC肿瘤或坏死灶手术切除及颞肌瓣修复治疗的患者进行回顾性分析。分析修复效果及患者术后情况。本研究共纳入29例患者，其中男性19例，女性10例，年龄33至65岁，随访6至35个月。除2例因出血或特殊细菌感染未随访外，其余患者颞肌瓣愈合良好，未发生脑脊液鼻漏或大出血。术后所有患者均无鼻咽反流或新的开放性鼻音，部分患者开放性鼻音甚至得到缓解。除1例因感染导致颞窝凹陷并随后清创，另1例额部皱纹变浅外，其余患者外观基本对称。部分患者术后有暂时性张口受限，经康复锻炼后均恢复。颞肌瓣可保护颅底和颈内动脉，提高NPC或坏死灶切除术后患者的生活质量。它是一种可靠的带蒂皮瓣，用于修复颅底缺损，手术操作简单，并发症相对较少。
