腓骨瓣联合小腿外侧皮瓣修复颌面缺损

摘要

目的 探讨腓骨瓣联合小腿外侧皮瓣修复口腔颌面软、硬组织缺损的临床疗效.方法 以腓动、静脉为血管蒂腓骨瓣联合小腿外侧皮瓣进行颌面部软、硬组织缺损修复,腓骨用于修复颌骨缺损,小腿外侧皮瓣主要用于修复口底、牙龈、咽侧、颊以及腭部的软组织缺损.结果 2005年3月至2007年3月,共治疗26例,其中修复恶性肿瘤术后缺损25例,双侧上颌骨缺失1例.术中组织瓣制备顺利,没有出现伤及腓骨血管以及小腿外侧皮瓣的穿支血管的现象.所有移植组织瓣全部成活.其中有1例术后12 h出现吻合动脉危象,经抢救成活;1例术后24 h出现静脉吻合危象,静脉血栓形成,经手术探查,重新吻合静脉后,抢救成功.术后随访6个月至2年,修复区外形满意,患者能从事正常的社会活动.结论 腓骨瓣联合小腿外侧皮瓣修复口腔颌面部复合组织缺损效果较好.可作为首选方法.%Objective To investigate the therapeutic effect offibular flap combined with lateral crural flap for reconstruction of oral and maxillofacial defeet.Methods Based On the peroneal vascular system,fibular flap combined withlateral cmralflapwere u8edfor reconstruction oforal andmaxillofacial defect.The fibular flap was used for bone defect.and the lateral crural flap was for the reconstruction of soft tissue defect of the oral cavity and pharynx.Results During the period of Mar.2005 to Mar.2007,26 cases were treated,including 25 cases of defects after tumor resection and 1 case of bilateral maxillary defect.The flaps were harvested without any injury to the peroneal vascular system and perforator.All the flaps welre survived.One earle of arterial instrltieieney and one case of venous thrombosis occurred 12 hours and 24 hours after operation,but the flaps were salvaged after urgent re-operation.All the patients were followed up for 6 months to 2 years.The patients acquired satisfactory appearsnee with normal social life.Conclusions For complicated oral and maxiUofacial reconstruction,fibular flap combined with lateral crural flap can achieve good reconstruction results and could be selected as the first line treatment.