Belli E, Cicconetti A, Matteini C
Cattedra di Chirurgia Maxillo-Facciale, Facoltà di Medicina e Chirurgia, Università degli Studi di Roma La Sapienza.
Minerva Stomatol. 1995 May;44(5):223-33.
The concentration in a restricted area such as the oral cavity of the essential anatomic structures for mastication, deglutition, speech, salivary drainage and respiration makes it indispensable to ensure not only the structural reconstruction of the region but also, and above all, a functional reconstruction of the anatomic unit affected by resection. The use of revascularised flaps has extended both the quantity and quality of reconstructive methods available. In the context of the oral cavity the most widely used flaps are the radial forearm free flap and jejunum free flap. In this paper the authors report their personal experience in a group of 13 patients (6 radial forearm and 7 jejunum) undergoing oral cavity reconstruction using free flap. For each flap the authors describe the microsurgical procedure, the clinical characteristics of the post-operative period, the locoregional complications, the donor site and lastly the long-term clinical, anatomopathological and functional modifications 6-12 months after primary treatment. Moreover, they highlight the varying characteristics of the two flaps and make a critical assessment of the advantages and disadvantages of using one or other method. Lastly, in the light of their experience and a review of international literature, the authors underline the importance of making a careful choice and personalized reconstruction, and finally outline their own criteria of choice.
在诸如口腔这样的受限区域内，咀嚼、吞咽、言语、唾液引流及呼吸等重要解剖结构高度集中，这使得不仅要确保该区域的结构重建，而且最重要的是要对受切除影响的解剖单元进行功能重建，这一点不可或缺。带血管蒂皮瓣的应用扩展了可用重建方法的数量和质量。在口腔重建领域，应用最为广泛的皮瓣是桡侧前臂游离皮瓣和空肠游离皮瓣。在本文中，作者报告了他们在一组13例接受游离皮瓣口腔重建患者（6例采用桡侧前臂皮瓣，7例采用空肠皮瓣）中的个人经验。对于每一例皮瓣，作者描述了显微外科手术过程、术后阶段的临床特征、局部区域并发症、供区情况，最后还阐述了初次治疗后6至12个月的长期临床、解剖病理及功能改变。此外，他们强调了这两种皮瓣的不同特点，并对使用其中一种或另一种方法的优缺点进行了批判性评估。最后，根据他们的经验以及对国际文献的回顾，作者强调了谨慎选择和个性化重建的重要性，并最终概述了他们自己的选择标准。
