关键词:
anterolateral femoral myocutaneous flap
malignant tumor
maxillary defect
oral repair membrane
repair and reconstruction
摘要:
目的:探讨游离股前外侧肌皮瓣联合口腔修复膜在上颌恶性肿瘤术后合并鼻腔黏膜缺损修复重建中的临床效果。 方法:选取2020年11月至2023年11月期间,于首都医科大学附属北京安贞医院南充医院口腔颌面外科接受手术治疗的上颌牙龈鳞状细胞癌及上颌窦癌患者共12例。所有患者均采用游离股前外侧肌皮瓣移植联合口腔修复膜,同期对肿瘤切除术后遗留的上颌软组织、硬组织及鼻腔黏膜缺损进行修复与重建。术后随访6~12个月。 结果:术中行上颌骨次全切除1例,全切除9例,扩大切除2例。术后12例肌皮瓣全部成活,面部外形基本对称,无明显凹陷畸形;吞咽、语言功能恢复良好,口-鼻腔封闭完全,均可经口进食,无鼻腔通气障碍。 结论:对于上颌恶性肿瘤术后合并上颌大范围组织及鼻腔黏膜缺损,应用游离股前外侧肌皮瓣联合口腔修复膜进行修复重建,术后外形及功能恢复良好,是上颌恶性肿瘤术后合并鼻腔黏膜缺损修复重建的一种选择。.;Objective:To investigate the clinical effect of free anterolateral thigh myocutaneous flap combined with oral repair membrane in the reconstruction of nasal mucosa defect after maxillary malignant tumor surgery. Methods:A total of 12 patients with maxillary gingival squamous cell carcinoma and maxillary sinus cancer who had been treated in Department of Oral and Maxillofacial Surgery, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, were selected from November 2020 to November 2023. Free anterolateral thigh musculocutaneous flap transplantation combined with oral repair membrane were used in all patients. Meanwhile, maxillary soft and hard tissue defects and nasal mucosa defects left after tumor operation were repaired and reconstructed. The clinical effect was evaluated after 6-12 months follow-up. Results:Subtotal maxillary resection was performed in 1 case, total maxillary resection in 9 cases and extended maxillary resection in 2 cases. The musculocutaneous flaps of all patients survived, the facial appearance was basically symmetrical, no obvious depression deformity, the swallowing and speech function recovered well, the mouth and nasal cavity were closed completely, the food could be eaten through the mouth, and the lower nasal passage was not blocked. Conclusion:The free anterolateral thigh musculoflap combined with oral repair membrane can be used to repair and reconstruct maxillary malignant tumor complicated with extensive maxillary tissue and nasal mucosa defect after operation, and the appearance and function can be recovered