应用游离背阔肌肌皮瓣修复局部晚期头颈部肿瘤术后缺损

摘要

目的 探讨不同类型的游离背阔肌肌皮瓣在修复复杂头颈部缺损中的临床效果.方法 自2003年6月至2012年6月,应用游离背阔肌肌皮瓣修复晚期头颈部肿瘤术后大面积缺损15例,所有患者均为Ⅳ期.应用游离背阔肌肌皮瓣16块,修复口 腔颌面部洞穿性缺损4例,修复侧颅底及腮腺区缺损7例,修复颈部缺损3例,修复前颅底及眶区缺损1例.皮瓣类型包括背阔肌肌皮瓣8块,双岛状背阔肌肌皮瓣4块,带肌袖的胸背动脉穿支皮瓣4块.皮瓣大小6 cm×10 cm～10 cm×20 cm.结果 16侧皮瓣中1例坏死,其他全部存活.3例接受术后放疗的患者皮瓣全部存活未受放疗影响.结论 游离背阔肌肌皮瓣适合用于修复头颈部大型复杂缺损.%Objective To explore the value of free latissimus dorsimyocutaneous flap in repairing severe defect of head and neck after resection of tumor.Methods Free latissimus dorsimyocutaneous flap was used to repair defect after resection of tumor in 12 patients (13 sides) with head and neck tumors.Of them 2 cases underwent radical radiotherapy before operation.and 3 cases received adjuvant radiotherapy postoperatively.Results Aside from one flap with necrosis, other 12 flaps survived after operation including 5 cases with radiotherapy.Conclusion Free latissimus dorsimvocutaneous flap can afford large tissue, has reliable blood supply, is easy to survive, and resist to radiotherapy, which is fit for repairing severe defect of head and neck.