胸锁乳突肌肌皮瓣修复口底恶性肿瘤术后缺损疗效研究.docVIP

胸锁乳突肌肌皮瓣修复口底恶性肿瘤术后缺损疗效研究[摘要]目的:探讨胸锁乳突肌肌皮瓣修复口底癌术后缺损的疗效。方法:回顾性分析5例口底癌术后缺损采用胸锁乳突肌肌皮瓣进行修复治疗,术后6个月、1年、2年随访。结果:5例中1例肌蒂皮瓣全部成活,3例远端部分发生坏死,肉芽组织生长修复;1例表皮脱落后上皮再生愈合。随访6个月～2年,口底形态及功能恢复良好,舌活动度良好,未见肿瘤复发或淋巴结转移。结论:胸锁乳突肌肌皮瓣血供恒定,容易成活,适用于口底缺损的修复。 [关键词]胸锁乳突肌肌皮瓣;口底癌;疗效分析 [中图分类号]R782 [文献标识码]A [文章编号]1008-6455(2010)06-0850-02 Clinical effects of sternocleidomastoid myocutaneous flap in repairing defect of oral floor after resection of oral cancer:A retrospective study of 5 patients GU Hui-zhen1,GAO Ling2,ZHI Ke-qian2,REN Wen-hao2 (1.Department of stomatology, Qinghai Provincial People’s Hospital, Xining 810007,Qinghai,China;2. Department of Oral and Maxillofaical Surgery,Stomatological Hospital,College of Medicine,Xi’an Jiaotong University) Abstract:ObjectiveTo evaluate the clinical effects of 5 consecutive sternocleidomastoid(SCM)myocutaneous flaps used for the reconstruction after resection of carcinoma of floor of mouth.Methods5 patients with defect of oral floor treated by SCM myocutaneous flaps were reviewed retrospectively.The period of follow-up was from 6 month to 2 years.Results Partial necrosis in 3 patients growth with granulation tissue and in 1 patient, the region of epithelial loss healed and re-epithelialized without further therapy. 5 patients’ appearance and function were improved and the tongue had no difficulty in speech intelligibility. In addition, there were no recurrence or lymph node metastasis.Conclusions The SCM myocutaneous flap appears to be simple to use and useful for reconstruction of the defect after resection of oral carcinoma. Key words: sternocleidomastoid(SCM) myocutaneous flaps; carcinoma of floor of mouth; efficacy analysis 胸锁乳突肌肌皮瓣已作为一种岛状皮瓣用于口底、下颌骨等相关疾病口内缺损的重建[1-2],但由于该皮瓣其肌肉内侧面靠近颈内淋巴结,可能发生肿瘤转移,若术后放疗往往会出现皮瓣坏死等不良反映使其初期没有得到广泛应用[3]。近年来由于手术技术及诊断水平的提高,该皮瓣的应用逐渐受到重视。现回顾性分析我科5例采用胸锁乳突肌皮瓣同期修复口腔癌术后组织缺损患者,均取得较满意的效果。 1资料和方法 1.1一般资料:5例(男4例,女1例)行胸锁乳突肌肌皮瓣修复口底缺损者,年龄31～65岁。其中鳞癌1例,腺样囊性癌3例,粘液表皮样癌1例。术前经 CT、MRI及B超检查,TNM分期:T2N0M03例,T3N0M01例,T3N1M