【作者】 潘朝斌； 黄洪章； 李劲松； 赵小朋； 张彬； 王建广； 杨朝晖；

【Author】 Pan Chao-bin, Huang Hong-zhang, Li Jin-song, Zhao Xiao-peng, Zhang Bin, Wang Jian-guang, Yang Zhao-hui Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Sun Yat-sen University

【机构】 中山大学附属第二医院口腔颌面外科；

【摘要】 <正>目的:探讨应用带肋胸膜的肋骨-胸大肌复合瓣联合修复晚期口腔癌根治术后口腔软硬组织大型缺损的临床效果和安全性。方法:从2004年2月至2006年3月,对10例累及同侧口底和下颌骨并越过中更多还原

【Abstract】 Objective: To explore the clinical value and safety of using rib-major pectoralis myocutaneous flap carrying costal parietal pleura in combined repair of large soft and hard tissue defect caused by radical surgery of advanced cancer in oral and maxillo-facial region. Methods: From February 2004 to March 2006, 10 patients with advanced tongue carcinoma or gingival carcinoma involving the floor of mouth and mandible were performed combined radical neck dissection with glossectomy and mandibulectomy, which caused large soft and hard tissue defect. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura were transferred for immediate repair of the large defects. The rib flaps were applied for the repair of mandible, and the major pectoralis myocutaneous flaps were applied for the reconstruction of tongue and floor of mouth.. Results: Ten patients tided over perioperation safely. There were no pneumothorax and pneumonia after operation. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura survived well, and the wounds of surgical incision of the oral cavity, neck, and chest healed up. The reconstructed tongue and the lower face appearance were satisfactory, and the occlusion relationships were normal, and the speaking as well as swallowing functions recovered. Conclusion: It’s safe and reliable to use rib-major pectoralis myocutaneous flap carrying costal parietal pleura to repair large soft and hard tissue defect in oral and maxillo-facial region. Opening pleural cavity and harvest costal parietal pleura would not inference patients’ thoracic movement and breath function and would not cause other complications. It’s simple and safe for harvesting the complex flap. Carrying costal parietal pleura assures the sufficient blood supply of rib in the complex flap. The technique is worthwhile to popularize and apply.更多还原