Ross U H, Klenzner T
Universitäts-Hals-Nasen-Ohrenklinik Freiburg.
Laryngorhinootologie. 1998 Mar;77(3):168-71. doi: 10.1055/s-2007-996954.
Among the myocutaneous island flaps applied for reconstruction of large soft-tissue defects after ablative surgery for malignomas, the pectoralis major flap is the one most frequently used. In comparison, the sternocleidomastoid myocutaneous island flap is not as popular.
We report on our experiences with the superiorly based sternocleidomastoid myocutaneous (SCM) island flap (cutaneous island of 6-8 cm in diameter) in seven consecutive cases after resection of malignomas of the oral cavity and the pharynx. The vascularization from the occipital artery is additionally supplied by preserving the platysma during preparation of the SCM flap.
Only one total cutaneous necrosis was observed in a patient who had received prior radiation. In the other 6 cases no major complications (necrosis or fistula) occurred.
When the preservation of the sternocleidoid muscle does not compromise oncologic principles as in cases with limited lymphe node involvement (N0-N1), the SCM flap appears to be a useful and simple technique, particularly in female patients compared with the pectoralis major flap, in addition to others.
在用于恶性肿瘤切除术后大的软组织缺损重建的肌皮岛状皮瓣中,胸大肌皮瓣是最常用的一种。相比之下,胸锁乳突肌肌皮岛状皮瓣则不太受欢迎。
我们报告了在7例口腔和咽部恶性肿瘤切除术后连续使用以枕动脉为蒂的胸锁乳突肌肌皮(SCM)岛状皮瓣(直径6 - 8厘米的皮岛)的经验。在制备SCM皮瓣时通过保留颈阔肌,额外提供来自枕动脉的血供。
仅1例曾接受过放疗的患者出现了完全皮肤坏死。在其他6例中未发生重大并发症(坏死或瘘管)。
当保留胸锁乳突肌不影响肿瘤学原则时,如在淋巴结受累有限(N0 - N1)的病例中,SCM皮瓣似乎是一种有用且简单的技术,特别是与胸大肌皮瓣相比,对女性患者尤其如此,此外还有其他优点。