Bootz F, Plinkert P K
Universitäts-HNO-Klinik Tübingen.
HNO. 1993 May;41(5):268-73.
Salivary fistulas after laryngectomy and radiotherapy can be treated with different reconstructive procedures if spontaneous closure fails to occur. In small fistulas local supraclavicular flaps are useful if not altered by radiotherapy. Larger fistulas can be closed with pectoralis major flaps. If these methods fail and there is a large defect in the pharynx, free tissue transplants can be used. For this purpose the "single" or "double" jejunal patch can be recommended. The double patch is used for fistulas with large skin defects, since the outer patch from which the mucosa is removed will take split skin. If there is severe infection and tissue alteration by radiotherapy, free omentum transplantation is an excellent method for closure of a fistulas, since in addition to immunological reactivity it easily takes split skin. the vanous methods mentioned are not equal in their applications and are used depending on the size of defect present. In particular, the use of intestinal grafts depends on the general health of the patient affected.
喉切除术后及放疗后发生的唾液瘘，若不能自行闭合，可采用不同的重建手术进行治疗。对于小瘘口，如果未因放疗而改变，局部锁骨上皮瓣是有用的。较大的瘘口可用胸大肌皮瓣闭合。如果这些方法失败且咽部存在大的缺损，则可使用游离组织移植。为此，可推荐“单”或“双”空肠补片。双补片用于伴有大面积皮肤缺损的瘘口，因为去除黏膜的外层补片可接受中厚皮片移植。如果存在严重感染且因放疗导致组织改变，游离大网膜移植是闭合瘘口的极佳方法，因为除了免疫反应性外，它很容易接受中厚皮片移植。上述各种方法在应用上并不相同，需根据存在的缺损大小来使用。特别是，肠道移植的使用取决于受影响患者的总体健康状况。
