Elshal E E, Inokuchi T, Sekine J, Sano K
Second Department of Oral and Maxillofacial Surgery, Nagasaki University School of Dentistry, Japan.
J Oral Maxillofac Surg. 1997 Dec;55(12):1423-30; discussion 1431-2. doi: 10.1016/s0278-2391(97)90643-1.
The purpose of this study was to observe the epithelialization process of the muscle-only flap used for reconstruction of the oral mucosal defects.
Forty-three male adult Japanese rabbits were used. A superiorly based cleidomastoid muscle flap was designed after vascular assessment. The flap was transferred into the oral cavity to cover a mucoperiosteal defect made in the mandibular alveolus. Epithelialization of the flap was histologically evaluated at designated intervals.
The flaps survived without ischemic necrosis. By 8 days postoperation, the flap was infiltrated by acute inflammatory cells and being replaced by granulation tissue originating from the adjacent tissues. The oral epithelial cells advanced onto this granulating muscle flap, with eventual coverage by 21 days. The granulation tissue matured to fibrous tissue with significant contraction by 2 months. At 6 months postoperation, abnormally hyperkeratinized epithelium was seen on the flap. This differed from the surrounding parakeratinized oral epithelium.
The muscle-only flap in the oral cavity epithelializes after the granulation process.
本研究旨在观察用于修复口腔黏膜缺损的单纯肌肉瓣的上皮化过程。
选用43只成年雄性日本白兔。在进行血管评估后设计了以锁骨乳突肌为蒂的肌瓣。将该肌瓣转移至口腔，覆盖下颌牙槽突形成的黏骨膜缺损。在指定时间间隔对肌瓣的上皮化进行组织学评估。
肌瓣存活，未发生缺血性坏死。术后8天，肌瓣被急性炎性细胞浸润，并被源自相邻组织的肉芽组织替代。口腔上皮细胞向该肉芽化的肌瓣推进，最终在21天时覆盖完毕。肉芽组织在2个月时成熟为纤维组织，并出现明显收缩。术后6个月，在肌瓣上可见异常过度角化的上皮。这与周围的不全角化口腔上皮不同。
口腔内的单纯肌肉瓣在经历肉芽形成过程后发生上皮化。
