【作者】 苏彤； 胡永杰； 唐瞻贵； 张陈平；

【Author】 SU Tong2,HU Yong-jie1,TANG Zhan-gui2,ZHANG Chen-ping1 (1.Dept.of Oral and Maxillofacial Surgery,Ninth people’s Hospital,Shanghai Jiao Tong University,Shanghai 200011,China 2.Dept.of Oral and Maxillofacial Surgery,XiangYa Hospital,Central South University,Changsha 410008,China)

【机构】 中南大学湘雅医院、湘雅口腔医学院口腔颌面外科； 上海交通大学医学院附属第九人民医院、口腔医学院口腔颌面外科；

【摘要】 目的:探索应用个体化设计的游离股前外侧复合肌皮瓣(anterolateral thigh combined flap,ALTCF)修复颊癌复合缺损的效果。方法:2006～2008年应用个体化设计的游离股前外侧复合肌皮瓣修复13例颊癌复合缺损的患者,观察并评估患者术后面部形态及功能。结果:13例游离ALTCF手术均获成功。面部外形及口腔功能恢复良好;受区及供区伤一期愈合,未发现口底瘘、下肢运动和感觉功能障碍等并发症。10例皮瓣的穿支血管类型为肌皮穿支,3例为肌间隙穿支;皮瓣大小为(4～8)cm×(8～12)cm,所携带股外侧肌大小为(2～5)cm×(3～6)cm。结论:个体化设计的游离股前外侧复合肌皮瓣具有可重建良好的颊部形态,封闭口底、颌下缺损形成的死腔,恢复张口度,供区部位隐蔽和并发症少等优点,是颊癌复合缺损修复的理想皮瓣。更多还原

【Abstract】 Objective:To explore the personalized designed free anterolateral thigh combined flap(ALTCF) for reconstruction of buccal carcinoma combined defect.Methods:A retrospective review was performed of 13 personalized designed ALTCF reconstructions for buccal carcinoma combined defects between 2006 and 2008,The operative technique of ALTCF was described,facial contour and oral function were evaluated.Results:All 13 free flaps survived,facial contour and oral function were satisfied,no complication was observed in the donor site,like wound dehiscence,weakness of the legs,The anatomy of the perforators were recognized as musculocutaneous pattern in 10 cases and septocutaneous pattern in 3 cases.The size of the flap ranged from(4～8)cm×(8～12)cm and the size of the muscle flap ranged from(2～5)cm×(3～6)cm.Conclusions:Personalized designed free ALTCF is a reliable reconstruction technique for buccal carcinoma combined defects,because of the minimum donor site morbidity and the concealed site,this flap is the ideal choice and it was better than those of forearm flap,pectoralis major myocutaneous flap and latissimus dorsi myocutaneous flap to reconstruct buccal carcinoma combined defects.更多还原