【摘要】 目的:研究颈阔肌肌皮瓣在口底恶性肿瘤切除术后口底组织缺损即刻修复中的应用价值。方法:对9例口底恶性肿瘤切除后遗留的口底组织缺损行颈阔肌肌皮瓣修复,其中6例口底鳞癌患者修复与颈淋巴清除术同期进行,1例同时行下颌骨矩形方块切除,3例为舌下腺腺样囊性癌患者行口底局部扩大切除术。结果:9例颈阔肌肌皮瓣全部成活;3例在肌皮瓣尖端与舌腹部黏膜组织间出现裂开,长2.0～3.0cm,给予清创重新缝合后愈合;3例皮瓣远端少许淤血,未影响愈合。术后6个月复查,所有患者皮瓣收缩不明显,所修复的口底形态及舌体活动功能良好。结论:颈阔肌肌皮瓣血供丰富、解剖恒定可靠、邻近口腔、制作方便、简单快捷和成功率高,是修复口底组织缺损的一种安全选择。更多还原

【Abstract】 OBJECTIVE:To study the applied value of platysma myocutaneous flap in reconstruction tissue defects of the floor of mouth.METHODS:Nine patients with floor of mouth carcinoma underwent immediate reconstruction of intraoral defects using the platysma myocutaneous flaps.A supraomohyoid neck dissection was performed in 6 patients with squamous cancer.1 patient received the rectangular resection of the mandibular bone.Three patients with sublingual gland adenoid cystic carcinoma were trented with expanded resection at the bottom of mouth.RESULTS:In all the 9 cases,platysma myocutaneous flaps survived totally and no necrosis happened,no obvious obstruction occured after radiotherapy.Three patients who had wound dehiscence between the flaps tip and the belly of tongue(2.0-3.0 cm) received the debriment and suture again,the satisfactive appearance and better tongue movement function were achieved.Three patients had extravasated blood which didn’t affect the healing up.Six months after operation,all the patients got good treatment outcome.CONCLUSION:Platysma myocutaneous flap provide a good method for the reconstruction of floor of mouth tissue defects after resection of mouth floor cancers because of its generous blood supply,the conveniences of performance and the high survival rate.更多还原