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用于口腔癌复杂缺损重建的嵌合型股前外侧皮瓣：三例报告

Chimeric anterolateral thigh flap for reconstruction of complex defects in oral cancer: a report of three cases.

作者信息

Kim Hyo-Sik, Ahn Kang-Min, Lee Jee-Ho

机构信息

Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2024 Dec 31;50(6):361-366. doi: 10.5125/jkaoms.2024.50.6.361.

DOI:10.5125/jkaoms.2024.50.6.361
PMID:39743334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11701506/
Abstract

It is crucial to reconstruct extensive soft tissue defects following oral cancer resection to restore both function and aesthetics. Single anterolateral thigh flaps may not suffice for large defects. This report highlights the use of chimeric flaps, which feature multiple paddles with individual perforators, to reconstruct large intraoral and extraoral defects, adapting to wide defects, and covering areas with extensive tissue damage. This case series demonstrates the adaptability and effectiveness of chimeric flaps, demonstrating them to be a superior option for satisfactory healing and functional outcomes in reconstruction of complex defects.

摘要

口腔癌切除术后重建广泛的软组织缺损以恢复功能和美观至关重要。对于大面积缺损，单股前外侧皮瓣可能不够用。本报告重点介绍了嵌合皮瓣的应用，该皮瓣具有多个带有独立穿支的皮瓣，用于重建口腔内和口腔外的大面积缺损，适应广泛的缺损，并覆盖组织损伤广泛的区域。该病例系列证明了嵌合皮瓣的适应性和有效性，表明它们是重建复杂缺损时实现满意愈合和功能结果的更佳选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/6b72a65ddca2/jkaoms-50-6-361-f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/74b6d5ff54d0/jkaoms-50-6-361-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/ef3458722172/jkaoms-50-6-361-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/5ed708a38f63/jkaoms-50-6-361-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/b4e60284871a/jkaoms-50-6-361-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/746af621a5b0/jkaoms-50-6-361-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/ab5613d15626/jkaoms-50-6-361-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/c18d0a1553a1/jkaoms-50-6-361-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/6b72a65ddca2/jkaoms-50-6-361-f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/74b6d5ff54d0/jkaoms-50-6-361-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/ef3458722172/jkaoms-50-6-361-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/5ed708a38f63/jkaoms-50-6-361-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/b4e60284871a/jkaoms-50-6-361-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/746af621a5b0/jkaoms-50-6-361-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/ab5613d15626/jkaoms-50-6-361-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/c18d0a1553a1/jkaoms-50-6-361-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5916/11701506/6b72a65ddca2/jkaoms-50-6-361-f8.jpg

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本文引用的文献

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Anterolateral Thigh Chimeric Flap: An Alternative Reconstructive Option to Free Flaps for Large Soft Tissue Defects.股前外侧嵌合皮瓣：用于大面积软组织缺损的游离皮瓣替代重建选择。
J Clin Med. 2023 Oct 24;12(21):6723. doi: 10.3390/jcm12216723.
2
Application of a new classification of chimeric anterolateral thigh free flaps.新型嵌合游离股前外侧皮瓣的分类应用。
J Craniomaxillofac Surg. 2019 Aug;47(8):1198-1202. doi: 10.1016/j.jcms.2019.01.035. Epub 2019 Feb 1.
3
Use of the chimeric anterolateral thigh free flap in lower extremity reconstruction.
嵌合型股前外侧游离皮瓣在下肢重建中的应用。
Microsurgery. 2015 Nov;35(8):634-9. doi: 10.1002/micr.22494. Epub 2015 Sep 14.
4
Reconstruction of Complex Total Parotidectomy Defect With a Chimeric Anterolateral Thigh Perforator Flap and Vascularized Motor Branch of Femoral Nerve Grafting.采用嵌合型股前外侧穿支皮瓣及带血管蒂股神经运动支移植修复腮腺全切除术复杂缺损
J Oral Maxillofac Surg. 2015 Dec;73(12):2448.e1-7. doi: 10.1016/j.joms.2015.08.010. Epub 2015 Aug 18.
5
Combined Anterolateral Thigh and Anteromedial Thigh Flap for Extensive Extremity Reconstruction: Vascular Anatomy and Clinical Application.股前外侧和股前内侧联合皮瓣用于四肢广泛重建：血管解剖与临床应用
J Reconstr Microsurg. 2015 Nov;31(9):674-80. doi: 10.1055/s-0035-1558985. Epub 2015 Aug 10.
6
Chimeric flaps pedicled with the lateral circumflex femoral artery for individualised reconstruction of through-and-through oral and maxillofacial defects.以旋股外侧动脉为蒂的嵌合皮瓣用于个体化修复贯通性口腔颌面部缺损。
Br J Oral Maxillofac Surg. 2015 Feb;53(2):148-52. doi: 10.1016/j.bjoms.2014.10.017. Epub 2014 Dec 12.
7
Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation.阔背阔肌（LD）游离皮瓣和重建钢板用于肿瘤消融后广泛的上下颌骨重建。
J Craniomaxillofac Surg. 2012 Dec;40(8):e293-300. doi: 10.1016/j.jcms.2012.01.006. Epub 2012 Feb 28.
8
Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: a case report.应用复合股前外侧皮瓣再造上下唇完全缺损 1 例报告
Microsurgery. 2012 Jan;32(1):60-3. doi: 10.1002/micr.20943. Epub 2011 Nov 24.
9
Complex reconstructions in head and neck cancer surgery: decision making.头颈癌手术中的复杂重建：决策制定
Head Neck Oncol. 2011 Mar 8;3:14. doi: 10.1186/1758-3284-3-14.
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Functional impairment after latissimus dorsi flap.背阔肌肌皮瓣术后的功能障碍
ANZ J Surg. 2009 Jan-Feb;79(1-2):42-7. doi: 10.1111/j.1445-2197.2008.04797.x.