中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2014年
9期
754-758
,共5页
口腔肿瘤%颏%外科皮瓣%修复外科手术%治疗结果
口腔腫瘤%頦%外科皮瓣%脩複外科手術%治療結果
구강종류%해%외과피판%수복외과수술%치료결과
Mouth neoplasms%Chin%Surgical flaps%Reconstructive surgical procedures%Treatment outcome
目的 探讨颏下岛状皮瓣修复口腔癌术后软组织缺损的疗效.方法 2010年2月至2013年3月,对30例口腔癌患者术后口腔软组织缺损应用颏下岛状皮瓣进行修复,对颏下岛状皮瓣的修复效果、优缺点、手术并发症、术后口腔功能恢复及肿瘤复发情况进行评价.采用SPSS软件进行统计分析.结果 制备的岛状皮瓣最小4 cm×6 cm,最大6cm×15cm;1例皮瓣术后发生浅层坏死,1例皮瓣完全坏死,修复成功率为96.7％(29/30);手术时间4.5 ～7.5 h,平均6.8h;住院时间11～18 d,平均13 d;13例(43.3％)采用预防性气管切开术;手术后发生面神经下颌缘支暂时性麻痹1例,颈部血肿1例,颌下区积液7例,切口感染2例;手术后开口度:恢复正常23例,轻度开口受限6例,重度开口受限1例;语音功能恢复情况优良29例,差1例;吞咽功能:普食26例,可进软食3例,仅能进流质饮食1例;本组患者随访6～19个月,中位随访时间13个月,随访期内出现局部复发4例,颈部复发2例.结论 颏下岛状皮瓣具有安全、可靠、简便的优点,适合修复无颈部淋巴结转移的口腔癌术后的中小型软组织缺损.
目的 探討頦下島狀皮瓣脩複口腔癌術後軟組織缺損的療效.方法 2010年2月至2013年3月,對30例口腔癌患者術後口腔軟組織缺損應用頦下島狀皮瓣進行脩複,對頦下島狀皮瓣的脩複效果、優缺點、手術併髮癥、術後口腔功能恢複及腫瘤複髮情況進行評價.採用SPSS軟件進行統計分析.結果 製備的島狀皮瓣最小4 cm×6 cm,最大6cm×15cm;1例皮瓣術後髮生淺層壞死,1例皮瓣完全壞死,脩複成功率為96.7％(29/30);手術時間4.5 ～7.5 h,平均6.8h;住院時間11～18 d,平均13 d;13例(43.3％)採用預防性氣管切開術;手術後髮生麵神經下頜緣支暫時性痳痺1例,頸部血腫1例,頜下區積液7例,切口感染2例;手術後開口度:恢複正常23例,輕度開口受限6例,重度開口受限1例;語音功能恢複情況優良29例,差1例;吞嚥功能:普食26例,可進軟食3例,僅能進流質飲食1例;本組患者隨訪6～19箇月,中位隨訪時間13箇月,隨訪期內齣現跼部複髮4例,頸部複髮2例.結論 頦下島狀皮瓣具有安全、可靠、簡便的優點,適閤脩複無頸部淋巴結轉移的口腔癌術後的中小型軟組織缺損.
목적 탐토해하도상피판수복구강암술후연조직결손적료효.방법 2010년2월지2013년3월,대30례구강암환자술후구강연조직결손응용해하도상피판진행수복,대해하도상피판적수복효과、우결점、수술병발증、술후구강공능회복급종류복발정황진행평개.채용SPSS연건진행통계분석.결과 제비적도상피판최소4 cm×6 cm,최대6cm×15cm;1례피판술후발생천층배사,1례피판완전배사,수복성공솔위96.7％(29/30);수술시간4.5 ～7.5 h,평균6.8h;주원시간11～18 d,평균13 d;13례(43.3％)채용예방성기관절개술;수술후발생면신경하합연지잠시성마비1례,경부혈종1례,합하구적액7례,절구감염2례;수술후개구도:회복정상23례,경도개구수한6례,중도개구수한1례;어음공능회복정황우량29례,차1례;탄인공능:보식26례,가진연식3례,부능진류질음식1례;본조환자수방6～19개월,중위수방시간13개월,수방기내출현국부복발4례,경부복발2례.결론 해하도상피판구유안전、가고、간편적우점,괄합수복무경부림파결전이적구강암술후적중소형연조직결손.
Objective To evaluate the effectiveness of the submental island pedicled flap (SIPF) for the repair of oral soft defects following oral cancer ablation.Methods Thirty consecutive patients undergoing resection of oral cancer followed by reconstruction with SIPF from February 2010 to March 2013 were reviewed.The effectiveness complications,oral function recovering and oncologic outcomes after reconstructive operation with SIPF were evaluated.SPSS software was used to analyze the data.Results The dimensions of SIPF ranged from a minimum of 4 cm ×6 cm to a maximum of 6 cm × 15 cm.Of the 30 flaps,28 were survival completely,one had superficial necrosis but healed with treatments,and one failed due to complete necrosis,with a survival rate of 96.7％ (29/30).Operative time ranged from a minimum of 4.5 hours to a maximum of 7.5 hours,mean 6.8 hours,and hospital stay time was 11-18 days,mean 13 days.Thirteen patients (43.3％) received tracheotomy before SIPF operation.Surgical or postoperative complications included temporary marginal mandibular never palsy in one case,neck hematoma in one case,hydrops in the mandibular region in 7 cases,and neck infectionin in 2 cases.Postoperative functional results showed mouth opening was normal in 23 patients,light limitation of mouth opening in 6 cases and obvious limitation of mouth opening in one case.The speech function was re-obtained satisfactorily in 29 patients,but one case with poor speech function.Most patients showed normal swallowing function,of them 26 patients on a full oral diet,3 patients on a soft diet and one patient on a liquid diet only.Postopeative follow-up time was for 6-19 months (median 13 months),and 4 patients had local recurrence and 2 patients had cervical lymph node metastases.Conclusion The SIPF is safe,reliable and simple for the reconstruction of middle-small oral soft defects following resection of early-stage oral cancer.
