游离延展上臂外侧皮瓣修复颊癌术后软组织缺损

摘要

目的 探讨游离延展上臂外侧皮瓣修复颊癌术后软组织缺损的临床疗效.方法 2011年1月至8月,应用游离延展上臂外侧皮瓣一期修复3例颊癌扩大切除术造成的软组织缺损,术前应用多普勒血流探测仪测量后桡侧副动脉无变异后,根据其走行,以及术中软组织缺损的面积、形态设计皮瓣,皮瓣均越过肱骨外上髁,面积为9 cm ×5 cm～10 cm×6 cm,血管蒂长约10 cm.供区创面直接拉拢缝合.结果 3例皮瓣均成活,其中1例因局部负压过大造成血管危象,经手术探查,减轻局部负压,术后皮瓣逐渐恢复正常.术后随访6～10个月,患者均无复发,颊部外观形态及功能恢复良好,2例供区局部有麻木感,6个月后症状减轻.结论 游离延展上臂外侧皮瓣厚度适宜、血供可靠,是修复颊癌术后软组织缺损的较好方法.%Objective To summary the application of the extended free lateral arm flaps for buccal soft tissue reconstruction after buccal cancer.Methods From January to August 2011,three patients underwent the operation of buccal defect reconstruction using the extended free lateral arm flap in onestage.PRCA was identificated with the Doppler probe.According to the mark of PRCA,size and shape of defects,the flaps were designed and extended to the lateral epicondyle of humerus.The flap size ranged from 9 cm × 5 cm to 10 cm × 6 cm with a pedicle of 10 cm in length.The wounds at donor sites were closed directly.Results Vascular crisis happened in one case due to local negative pressure,which resolved after emergency management.All the flaps survived completely.The patients were followed up for 6 to 10 months with no recurrence.Both the esthetic and functional results were satisfactory.Two cases suffered from numb feeling in donor sites which alleviated six months later.Conclusions The extended free lateral arm flap has reliable blood supply with appropriate thickness.It is an optional method for reconstruction of buccal defects after ablation of buccal cancer.