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
2015年
5期
392-396
,共5页
刘汉前%俞辉明%刘家武%房进%毛弛
劉漢前%俞輝明%劉傢武%房進%毛弛
류한전%유휘명%류가무%방진%모이
口腔肿瘤%外科皮瓣%生物膜%腭%修复外科手术
口腔腫瘤%外科皮瓣%生物膜%腭%脩複外科手術
구강종류%외과피판%생물막%악%수복외과수술
Mouth neoplasms%Surgical flaps%Biofilms%Palate%Reconstructive surgical procedures
目的 探讨采用颏下岛状皮瓣联合口腔修复膜重建腭部洞穿型缺损的临床效果.方法 2010年8月至2014年2月,南京医科大学附属淮安一院口腔科共完成13例上颌牙龈或腭部恶性肿瘤患者的手术治疗,其中病理诊断为鳞状细胞癌12例,腺样囊性癌1例;肿瘤临床分期为:Ⅱ期2例,Ⅲ期4例,Ⅳ期6例,未分期1例.对肿瘤扩大切除后所遗留的腭洞穿型缺损应用颏下岛状皮瓣进行重建,并用口腔修复膜重建缺损的鼻腔面.对重建后患者的语音,吞咽功能及开口度进行评价.结果 13例皮瓣全部成活,无手术相关的严重并发症发生;术后10例患者的语音功能恢复正常,2例有轻度语音功能障碍,1例重度语音障碍;9例患者恢复正常饮食,3例可进食软食,1例能进流质;有8例患者恢复正常开口,发生轻度开口受限4例,重度开口受限1例.结论 应用颏下岛状皮瓣联合口腔修复膜修复可能是一种重建腭部洞穿型缺损简单、安全、可靠的方法,并可获得较为满意的口腔功能恢复.
目的 探討採用頦下島狀皮瓣聯閤口腔脩複膜重建腭部洞穿型缺損的臨床效果.方法 2010年8月至2014年2月,南京醫科大學附屬淮安一院口腔科共完成13例上頜牙齦或腭部噁性腫瘤患者的手術治療,其中病理診斷為鱗狀細胞癌12例,腺樣囊性癌1例;腫瘤臨床分期為:Ⅱ期2例,Ⅲ期4例,Ⅳ期6例,未分期1例.對腫瘤擴大切除後所遺留的腭洞穿型缺損應用頦下島狀皮瓣進行重建,併用口腔脩複膜重建缺損的鼻腔麵.對重建後患者的語音,吞嚥功能及開口度進行評價.結果 13例皮瓣全部成活,無手術相關的嚴重併髮癥髮生;術後10例患者的語音功能恢複正常,2例有輕度語音功能障礙,1例重度語音障礙;9例患者恢複正常飲食,3例可進食軟食,1例能進流質;有8例患者恢複正常開口,髮生輕度開口受限4例,重度開口受限1例.結論 應用頦下島狀皮瓣聯閤口腔脩複膜脩複可能是一種重建腭部洞穿型缺損簡單、安全、可靠的方法,併可穫得較為滿意的口腔功能恢複.
목적 탐토채용해하도상피판연합구강수복막중건악부동천형결손적림상효과.방법 2010년8월지2014년2월,남경의과대학부속회안일원구강과공완성13례상합아간혹악부악성종류환자적수술치료,기중병리진단위린상세포암12례,선양낭성암1례;종류림상분기위:Ⅱ기2례,Ⅲ기4례,Ⅳ기6례,미분기1례.대종류확대절제후소유류적악동천형결손응용해하도상피판진행중건,병용구강수복막중건결손적비강면.대중건후환자적어음,탄인공능급개구도진행평개.결과 13례피판전부성활,무수술상관적엄중병발증발생;술후10례환자적어음공능회복정상,2례유경도어음공능장애,1례중도어음장애;9례환자회복정상음식,3례가진식연식,1례능진류질;유8례환자회복정상개구,발생경도개구수한4례,중도개구수한1례.결론 응용해하도상피판연합구강수복막수복가능시일충중건악부동천형결손간단、안전、가고적방법,병가획득교위만의적구강공능회복.
Objective To evaluate the clinical outcomes of submental island pedicled flap (SIPF) combination with bio-membrane in reconstructing palate defects after maxillofacial or palatal neoplasm resection.Methods There were 12 patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma.The clinical stages of tumours were]] in two patients,Ⅲ in four patients,Ⅳ in six patients(UICC 2002),and one patient with adenoid cystic carcinoma no staged.SIPFs were designed and created,and the tissue sides of the SIPFs were covered with bio-membrane to reconstruct the oral and the nasal sides of the defects respectively.Speech and swallowing functions and opening mouth were evaluated 6 months postoperatively.Results All flaps survived and no serious complications occurred.Ten patients achieved normal speech,two had intelligible speech,and one was with slurred speech;Nine patients resumed a solid diet,three with a soft diet,and one on a liquid diet.Eight patients recovered normal mouth opening,four emerged minor limitation of mouth opening,and one had serious limitation of mouth opening.Conclusions SIPF combined with bio-membrane is a safe,simple,and reliable method for reconstruction of piercing palate defect following neoplasm ablation,with satisfactory oral functions.
