薄型股前外侧皮瓣修复口腔软组织缺损

摘要

目的 探讨薄型股前外侧皮瓣在口腔软组织缺损修复中的临床特点与治疗效果.方法 2008年12月至2011年12月收治34例口腔肿瘤患者,切除肿瘤的同时,应用薄型股前外侧皮瓣进行修复,包括颊、舌、口底等处的缺损修复.术前应用B超检测股前外侧区域血管穿支处的皮下脂肪厚度,排除皮下脂肪厚度超过1.5 cm的过度肥胖患者.结果 34例中采用肌皮穿支26例,膈皮穿支8例.皮瓣全部存活,仅2例皮瓣发生部分坏死.皮瓣面积6 cm×4 cm ～8 cm×6 cm.术后随访2 ～36个月,平均16.6个月,受区组织缺损修复效果满意,供区愈合良好.结论 薄型股前外侧皮瓣修复口腔癌术后软组织缺损,术后外形佳,功能恢复与前臂皮瓣修复效果无明显区别,且对供区影响小.薄型股前外侧皮瓣组织量丰富,供区隐蔽,可以作为修复口腔癌术后软组织缺损的首选方法.%Objective To assess the clinical features and therapeutic effect of free thin anterolateral thigh flap for the reconstruction of intraoral defects.Methods The clinicopathologic data of 34 cases with oral carcinoma were obtained from Institute and Hospital of Stomatology,Nanjing University Medical School,from December 2008 to December 2011.These 34 patients underwent the simultaneous tumor resection and intraoral defects reconstruction with free thin anterolateral thigh flaps.The defects were located at tongue,buccal,mouth floor,and so on.The subcutaneous fat thickness of the flap at the site of the perforator is usually measured by ultrasound before the operation.If the thickness of the subcutaneous fat at the site of the perforator exceeded 1.5 cm,the patient was excluded from the study.Results There were 16 male and 18 female patients.The mean age was 55.4 years.Among the 34 patients,26 flaps with musculocutaneous perforators and 8 flaps with septocutaneous perforators were used.Partial flap necrosis occurred in 2 patients.Conclusions The free thin anterolateral thigh flap is the ideal soft tissue flap for the intraoral defects reconstruction.Satisfactory functional results can be achieved at recipient area with minimal morbidity at the donor site area.