目的 探讨3种肌皮瓣在口腔颌面部组织缺损修复中的临床效果和适应证.方法 对56例口腔颌面部组织缺损患者分别采用全额肌皮辩、颈阔肌肌皮瓣、胸锁乳突肌肌皮瓣进行转移修复.全额肌皮瓣主要用于颊粘膜、咽侧壁、口底组织缺损,胸锁乳突肌肌皮瓣主要用于口底及舌缺损,颈阔肌肌皮瓣主要用于面颊部皮肤缺损.结果 56例患者肌皮瓣完全成活54例,大部分成活2例,移植成功率100%.全额肌皮瓣30例全部成活,颈阔肌皮瓣全部成活15例,部分坏死1例.胸锁乳突肌肌皮瓣全部成活9例.部分坏死l例.额面部外形恢复良好,口腔功能明显改善.结论 3种肌皮瓣均可较好地修复口腔颌面部的组织缺损,应根据缺损的组织量、部位、缺损范围、供受区与手术野的关系灵活选用.%Objective To study the clinical effect and indication of the three kinds of musculocutaneous flap in repairing macro-tissues deficiency in oral-maxillofacial region.Methods 56 patients with oral maxillofacial carcinoma (OMC) were treated with transferring forehead muscnlocutaneous flap, the platysma myocutaneous flap and the sternodeiceomastoid myocutaneous flap.The forehead musculocutaneous flap was mainly applied to repair buccal mucosa, lateral wall of pharynx and the tissues defects of mouth floor.The sternodeiceomastoid myocutaneous flap was mainly applied to repair the defects of mouth's floor and tongue.The platysma myocutaneous flap was mainly applied to repair skin defects of face-cheek.Results Among the 56 patients, 54 cases survived completely, while the other 2 cases survived mostly.The success rate of transplantation was 100％.30 cases of the forehead musculocutaneous flap was a total success.While, to the platysma myocutaneous flap, 1 case was suffered with partial necrosis, the other 15 cases were successfully survived.To the sternodeiceomastoid myocutaneous flap, 1 case was suffered with partial necrosis, the other 9 cases were successfully survived.All patients were satisfactorily reconstructed both on their appearance and oral function.Moreover, the function of oral was significantly improved.Conclusion The three kinds of musculocutaneous flap can efficiently repair the tissues defects of oral-maxillofacial region.Therefore, the operation should be done according to the deficiency in the amount, the region, the area and the correlation between the supplied region and graft region.
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