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背阔肌游离肌皮瓣的临床解剖及其在头颈部巨大缺损修复中的应用

[Clinical anatomy of the free latissimus dorsi myocutaneous flap and its application in the restoration of giant defects of the head and neck].

作者信息

Qian Ye-Mei, Wang Wei-Hong, Zhu Jin, He Yong-Jing, Xu Biao, Zou Zhi-Rong, Shi Yan-An, Luo Lei, Li Jing-Yi

机构信息

Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University; Yunnan Key Laboratory of Stomatology. Kunming 650106, China. E-mail:

出版信息

Shanghai Kou Qiang Yi Xue. 2024 Jun;33(3):269-272.

Abstract

PURPOSE

To investigate the feasibility and effect of free latissimus dorsi myocutaneous flap in the reconstruction of giant head and neck defects.

METHODS

Free latissimus dorsi myocutaneous flap on the cadaver was simulated dissected, and measured by Image-Pro Plus 6.0 to assess the feasibility of repairing giant head and neck defects. Between May 2011 and September 2022, seven patients with giant head and neck defects of different causes repaired with the latissimus dorsi myocutaneous flap were retrospectively analyzed.

RESULTS

The diameter of the initiating thoracodorsal artery was (4.03±0.56) mm, and the mean lengths of the arteriolar and venous pedicles of the latissimus dorsi myocutaneous flaps obtained from human specimens were (85.5±10.5) mm and (104±4.2) mm, respectively. Among 7 patients, 5 cases had scalp defects, the remaining 2 cases had neck defects. There were no substantial postoperative problems in the donor site, and all seven latissimus dorsi myocutaneous flaps were successfully transplanted.

CONCLUSIONS

For the treatment of considerable head and neck deformities, the latissimus dorsi myocutaneous flap is an optimal muscle flap due to its abundance of tissue, enough length of vascular pedicles, and sufficient venous drainage.

摘要

目的

探讨背阔肌肌皮瓣游离移植修复巨大头颈部缺损的可行性及效果。

方法

在尸体上模拟解剖背阔肌肌皮瓣,并用Image-Pro Plus 6.0软件进行测量,以评估修复巨大头颈部缺损的可行性。回顾性分析2011年5月至2022年9月期间7例因不同原因导致巨大头颈部缺损并采用背阔肌肌皮瓣修复的患者。

结果

起始胸背动脉直径为(4.03±0.56)mm,取自人体标本的背阔肌肌皮瓣动脉蒂和静脉蒂平均长度分别为(85.5±10.5)mm和(104±4.2)mm。7例患者中,5例为头皮缺损,其余2例为颈部缺损。供区无明显术后问题,7块背阔肌肌皮瓣均成功移植。

结论

对于治疗严重的头颈部畸形,背阔肌肌皮瓣因组织丰富、血管蒂长度足够且静脉回流充分,是一种理想的肌皮瓣。

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