Pech A, Cannoni M, Zanaret M, Collignon G, Thomassin J M, Goubert J L
Ann Otolaryngol Chir Cervicofac. 1984;101(4):299-305.
Musculocutaneous flaps were used for reconstruction after excision of large base of tongue or lateral oropharyngeal wall tumors in 50 patients, the most frequently employed flap in both regions being one from pectoralis major. Results showed marked reliability for these types of flaps for repair in these two areas, and they have now supplanted conventional single pedicle skin flaps. Various flaps supplying different useful surfaces are required, the platysma or sternocleidomastoid muscles being used for small areas, the pectoral or trapezius muscles for medium sized gaps and the latissimus dorsi for extensive repairs. Postoperative and functional results were improved both after initial or repeat operations. The possibility of more extensive excisions should improve prognosis of these tumors, their severity being partly related to local recurrence. It is too early to conclude definitely in their use in initial surgery, but they are valid procedures following failure of radiotherapy, enabling certain patients to be treated again after 3 years in the absence of any other therapy.
在50例患者中,肌皮瓣用于舌根部或口咽侧壁大肿瘤切除后的重建,这两个部位最常用的皮瓣均来自胸大肌。结果表明,这些类型的皮瓣在这两个区域修复时具有显著的可靠性,现已取代传统的单蒂皮瓣。需要各种能提供不同有用表面的皮瓣,颈阔肌或胸锁乳突肌用于小面积修复,胸肌或斜方肌用于中等大小的缺损,背阔肌用于大面积修复。初次或再次手术后,术后效果和功能均得到改善。更广泛切除的可能性应能改善这些肿瘤的预后,其严重程度部分与局部复发有关。目前就其在初次手术中的应用下明确结论还为时过早,但在放疗失败后,它们是有效的治疗手段,能使某些患者在没有任何其他治疗的情况下3年后再次接受治疗。