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[一种应用神经血管舌骨下肌筋膜瓣进行舌重建的新方法]

[A new method of tongue reconstruction with neurovascular infrahyoid muscle-fascia flaps].

作者信息

Remmert S, Majocco A, Sommer K, Ahrens K H, Weerda H

机构信息

HNO-Klinik, Medizinische Universität Lübeck.

出版信息

Laryngorhinootologie. 1994 Apr;73(4):198-201. doi: 10.1055/s-2007-997110.

Abstract

Surgical treatment of tongue cancer can lead to extended defunctionalization, depending upon the size and localisation of the defect. Great problems of swallowing arise after total glossectomy or extensive resections of the base of the tongue even after reconstruction with myocutaneous island flaps or free flaps. We developed a neuromuscular island flap derived from the infrahyoidal musculature to reconstruct a total tongue or large defects of the tongue base. This fasciomuscular flap is formed by the M. sternothyroideus, M. sternohyoideus and the upper part of the M. omohyoideus. The axial blood supply arises from the A. thyroidea sup. The innervation is derived from the Ansa cervicalis N. hypoglossi. In case of total glossectomy we took this flap from both sides of the neck. With this new method we reconstructed total tongues after glossectomy in two patients and large defects of the tongue base in six patients. In the present paper the new surgical method and the functional results are described.

摘要

舌癌的手术治疗可能会导致功能的长期丧失,这取决于缺损的大小和位置。即使在采用岛状肌皮瓣或游离皮瓣进行重建后,全舌切除术或广泛的舌根切除术后仍会出现严重的吞咽问题。我们开发了一种源自舌骨下肌群的神经肌肉岛状皮瓣,用于重建全舌或舌根的大面积缺损。这种筋膜肌肉皮瓣由胸骨甲状肌、胸骨舌骨肌和肩胛舌骨肌上部构成。轴型血供来自甲状腺上动脉。神经支配来自颈袢舌下神经。在全舌切除的情况下,我们从颈部两侧获取该皮瓣。通过这种新方法,我们为两名患者在舌切除术后重建了全舌,为六名患者重建了舌根的大面积缺损。本文描述了这种新的手术方法及其功能结果。

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