Spiro R H, Sobol S M, Gerold F
Laryngoscope. 1983 Jan;93(1):32-5. doi: 10.1288/00005537-198301000-00006.
Resection of the entire tongue and floor of the mouth, with or without the anterior mandibular arch, may necessitate sacrifice of the larynx to prevent life-threatening aspiration and poses a significant reconstructive dilemma. Regional cutaneous or myocutaneous flaps can provide adequate healthy tissue for repair, but share the inherent disadvantage of resurfacing the oral cavity with skin (which may be hair bearing), rather than mucosa. Moreover, cutaneous flaps usually necessitate a planned orocutaneous fistula and secondary closure, and bulky myocutaneous flaps may interfere with oral competence. Larynx transposition has been used for some time at Memorial Sloan-Kettering Cancer Center to repair selected large oral cavity defects resulting from resection of the entire tongue and floor of the mouth. This report illustrates the laryngeal transposition flap which is developed from the skeletonized, laryngofissured larynx based on the superior laryngeal arteriovenous pedicle. The advantages and disadvantages of this technique, as compared with alternative methods of reconstruction, are discussed.
切除整个舌头和口腔底部，无论是否切除下颌前弓，都可能需要切除喉部以防止危及生命的误吸，并带来重大的重建难题。局部皮瓣或肌皮瓣可为修复提供足够的健康组织，但存在用皮肤（可能有毛发）而非黏膜重新覆盖口腔的固有缺点。此外，皮瓣通常需要计划性的口腔皮肤瘘和二期缝合，而体积较大的肌皮瓣可能会影响口腔功能。一段时间以来，纪念斯隆凯特琳癌症中心一直使用喉部移位术来修复因切除整个舌头和口腔底部而导致的特定大型口腔缺损。本报告介绍了基于喉上动静脉蒂的骨骼化、喉裂开喉部所形成的喉移位皮瓣。并讨论了该技术与其他重建方法相比的优缺点。
