目的：探讨颈阔肌肌皮瓣联合颊脂垫即刻修复颊部恶性肿瘤切除术后颊咽部组织缺损的应用价值。方法对11例颊部恶性肿瘤切除后遗留的颊咽部缺损行颈阔肌肌皮瓣和颊脂垫修复，所有患者修复与颈淋巴清扫术同期进行。结果10例肌皮瓣和9例颊脂垫全部成活，1例肌皮瓣远端部分出现瘀血感染坏死，2例颊脂垫出现部分坏死，给予清创修剪后愈合，1个月后口内所转移的肌皮瓣组织质地柔软，颊脂垫表面出现黏膜化，原清创区域为瘢痕组织愈合，所修复的颊咽部组织形态良好，经积极张口训练，术后10个月复查时8例患者张口无明显受限，3例患者轻度张口受限。结论颈阔肌肌皮瓣血供丰富、解剖恒定可靠、制作方便简单快捷、成功率高，颊脂垫柔软易伸展性、易塑形，是联合修复颊咽部组织缺损的一种可靠选择。%Objective To study the use of platysma myocutaneous flap compound with buccal fat pad flap in reconstruction of buccal and pharyngeal tissue defects. Methods 11 patients with buccal mucose carcinoma underwent immediate reconstruction of buccal and pharyngeal defects using the platysma myocutaneous flaps and buccal fat pad flap.At the same time neck dissection was performed in all patients. Results In the 11 cases, 10 platysma myocutaneous flaps survived,only 1 myocutaneous flaps had infection and part of tissue necrosis.9 buccal fat pad flaps survived,part of the other 2 buccal fat pad flaps necrosis,the overall appearance and function of buccal and pharyngeal were better.The degree of open mouth is normal in 8 cases,a little restriction in other 3 cases 10 months after operation. Conclusions Platysma myocutaneous flap has generous blood supply,easy to harvest,high survival rate,compound with buccal fat pad flap provide another method for the reconstruction of buccal and pharyngera tissue defects after resection of buccal mucose carcinoma.
展开▼
