改良下颌下腺瓣修复腮腺全切除术后组织缺损的功能重建
Functional reconstruction of tissue defects after total parotidectomy using a modified submandibular gland flap.
作者信息
Lu Hao, Xu Wanlin, Zhu Wenya, Wu Yifan, Yang Wenjun, Liu Shengwen
机构信息
Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China.
Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, PR China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, PR China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, PR China; Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai, PR China.
出版信息
J Stomatol Oral Maxillofac Surg. 2025 Feb;126(1):102022. doi: 10.1016/j.jormas.2024.102022. Epub 2024 Sep 5.
OBJECTIVE
Reconstruction of soft tissue defects after total parotidectomy requires a feasible and effective pedicled flap with sufficient volume. In this study, we introduce a modified submandibular gland flap (SMGF) for functional reconstruction of soft tissue defects resulting from total parotidectomy.
MATERIALS AND METHODS
This study included 12 patients diagnosed with parotid gland carcinoma undergoing total parotidectomy and ipsilateral selective neck dissection. The modified SMGF was harvested and transferred to the parotid bed. This procedure was coupled with anastomosis between the parotid gland duct and Wharton's duct. The feasibility of the surgery, postoperative complications, facial profile restoration, and salivary secretion were assessed.
RESULTS
All SMGFs pedicled only over the proximal facial artery survived without major complications. Facial profiles were well-restored, and salivary secretion was partially reserved. During the postoperative follow-up, no tumor recurrence was observed in any of the cases, and the volume of the SMGFs did not show obvious atrophy.
CONCLUSIONS
The modified SMGF is a viable solution for volume restoration and functional reconstruction after total parotidectomy.
CLINICAL RELEVANCE
This modified technique is simple and feasible for the functional reconstruction of soft tissue defects after total parotidectomy compared to other flaps and is worthy of clinical promotion.
目的
全腮腺切除术后软组织缺损的重建需要一个可行且有效的带蒂皮瓣，其要有足够的体积。在本研究中，我们介绍一种改良的下颌下腺皮瓣（SMGF），用于全腮腺切除术后软组织缺损的功能重建。
材料与方法
本研究纳入了12例诊断为腮腺癌并接受全腮腺切除术及同侧选择性颈清扫术的患者。切取改良的SMGF并转移至腮腺床。该手术同时进行腮腺导管与沃顿氏管的吻合。评估手术的可行性、术后并发症、面部外形恢复情况及唾液分泌情况。
结果
所有仅以面动脉近端为蒂的SMGF均存活，无严重并发症。面部外形恢复良好，唾液分泌部分得以保留。术后随访期间，所有病例均未观察到肿瘤复发，且SMGF的体积未出现明显萎缩。
结论
改良的SMGF是全腮腺切除术后体积恢复和功能重建的可行解决方案。
临床意义
与其他皮瓣相比，这种改良技术对于全腮腺切除术后软组织缺损的功能重建简单可行，值得临床推广。
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