Gal T J, Kerschner J E, Futran N D, Bartels L J, Farrior J B, Ridley M B, Klotch D W, Endicott J N
Division of Otolaryngology, University of South Florida College of Medicine, Tampa 33612, USA.
Laryngoscope. 1998 Apr;108(4 Pt 1):476-81. doi: 10.1097/00005537-199804000-00003.
Reconstruction of soft tissue defects after temporal bone resection can vary from simple closure of the external auditory canal to complex flap coverage of extensive defects. Between 1987 and 1996, 34 patients underwent lateral skull base resections and reconstruction for invasive carcinoma of the temporal bone. Seven underwent sleeve resection and/or radical mastoidectomy. Sleeve resection was managed with tympanoplasty, canalplasty, or obliteration of the external auditory canal (10). There were 24 lateral temporal bone resections and four subtotal temporal bone resections. Larger defects created by lateral and subtotal temporal bone resections required closure with a combination of temporalis flaps and local rotational cutaneous flaps (13). Lower island trapezius flaps (five), free flaps (four), and pectoralis major flaps (two) were also used. Indications and efficacy of each method are discussed, and treatment outcomes are presented.
颞骨切除术后软组织缺损的重建方法多样，从简单的外耳道封闭到复杂的大面积缺损皮瓣覆盖。1987年至1996年间，34例患者因颞骨浸润性癌接受了侧颅底切除及重建手术。7例行袖状切除和/或根治性乳突切除术。袖状切除采用鼓室成形术、外耳道成形术或外耳道闭塞术处理（10例）。有24例行外侧颞骨切除术和4例行颞骨次全切除术。外侧和颞骨次全切除造成的较大缺损需要联合颞肌皮瓣和局部旋转皮瓣进行封闭（13例）。还使用了低位岛状斜方肌皮瓣（5例）、游离皮瓣（4例）和胸大肌皮瓣（2例）。讨论了每种方法的适应证和疗效，并给出了治疗结果。
