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股前外侧肌皮瓣修复恶性肿瘤切除术后上颌骨缺损
游云华，汪跃平，梁军，张华伟，刘本艳游云华、汪跃平、梁军、张华伟、刘本艳，广东珠海 中山大学附属第五医院口腔颌面外科，519000
摘 要:目的 探讨股前外侧肌皮瓣修复颌面部组织缺损的临床应用效果。方法 对6例上颌骨恶性肿瘤患者行上颌骨扩大根治术，上颌骨组织大面积缺损用股前外侧肌皮瓣修复，切取的肌皮瓣长9.0～11.0 cm，宽4.0～6.0 cm。结果 1例皮瓣远端小部分坏死，其余5例皮瓣完全成活，外形恢复满意，下肢负重、行走不受影响。随访6～36个月，1例术后2年死于肿瘤肺转移，1例术后11个月复发，放射治疗后痊愈。结论 股前外侧肌皮瓣成活率高、面积大、外形满意，可用于上颌骨恶性肿瘤扩大根治术后大面积组织缺损的修复。
关键词:外科皮瓣； 上颌肿瘤； 修复外科手术
Thigh anterolateral musculocutaneous flap for repairing of maxillary bone defect following malignant tumor ablation
YOU Yun-hua，WANG Yue-ping，LIANG Jun，ZHANG Hua-wei，LIU Ben-yan.Department of Oral and Maxillofacial Surgery，Fifth Affiliated Hospital，Sun Yat-sen University，Zhuhai 519000，China
Abstract:Objective To investigate the clinical effect of the thigh anterolateral musculocutaneous flap for repairing tissue of maxillofacial region defcets. Methods Six patients of maxilla malignant tumors were treated with extensive radical resection of maxillary bone，The large maxillary bone tissue defects were reconstructed with thigh anterolateral musculocutaneous flap. The musculocutaneous flaps were 9 to 11 cm in length and 4 to 6 cm in width. Results Five cases of musculocutaneous flap survived completely with satisfactory shape except that one was necrosis in distal end subsection，the weight loading of lower limb and walking were not affected. After 2 years，one case was dead with tumor pulmonary metastasis，one case recrudesced after surgery and was cured by radiation therapy after 11 months，followed up 6 to 36 months. Conclusions The survival rate of thigh anterolateral musculocutaneous flap was satisfactory and areas were large enough，the reconstructed maxillofacial tissue were found to have good appearance. It′s an ideal choice for repairing oversized defects after extensive radical resection of maxilla malignant tumors.
Key words:Surgical flaps； Maxillary neoplasms； Reconstructive surgical procedures
文献标引:游云华，汪跃平，梁军，张华伟，刘本艳.股前外侧肌皮瓣修复恶性肿瘤切除术后上颌骨缺损[J/CD].中华临床医师杂志：电子版,2009,3(12):1985-1990.
参考文献:
[1] 罗力生，高建华，陈林峰，等. 股前外侧皮瓣及其游离移植的应用. 第一军医大学学报，1984，4（1）：1－3.
[2] 罗力生，徐达传，赵支森，等. 股前外侧皮瓣的解剖基础与临床应用. 中华整形烧伤杂志，1985，1（1）：50－52.
[3] Wei FC，Suominen S，Cheng MH，et al. Anterolateral thigh flap for postmastectomy breast reconstruction. Plast Reconstr Surg，2002，110（1）：82－88.[PubMed]
[4] Koshima I. Free Anterolateral Thigh Flap for Reconstruction of Head and Neck Defects following Cancer Ablation. Plast Reconstr Surg，2000，105（7）：2358－2360.[PubMed]
[5] 许亚军，寿奎水，芮永军，等. 600 例股前外侧皮瓣移植术的临床应用经验. 中华整形外科杂志，2005，21（6）：418－420.
[6] 唐举玉，李康华，刘俊，等. 股前外侧游离皮瓣修复足跟大面积软组织缺损. 中华整形外科杂志，2006，22（6）：436－438.
[7] Kimata Y，Uchiyama K，Ebihara S，et al. Versatility of the free anterolateral thigh flap for reconstruction of head and neck defects. Arch Otolaryngol Head Neck Surg，1997，123（12）：1325－1331.[PubMed]
[8] 黄文孝，陈杰，喻建军，等. 21例舌癌游离股前外侧皮瓣舌再造术临床体会. 中国肿瘤，2006，15（11）：779－781.
[9] 侯春林. 带血管蒂组织瓣移位手术图解. 2版. 上海：上海科学技术出版社，1998：132－134.
[10] You YH，Chen WL，Wang YP，et al. Reverse Facial-Submental Artery Island Flap for the Reconstruction of Maxillary Defects After Cancer Ablation. J Craniofac Surg，2009，20（6）：2217－2220.
[11] Clauser L，Curioni C，Spanio S. The use of the temporalis muscle flap in facial and craniofacial reconstructive surgery. A review of 182 cases. J Craniomaxillofac Surg，1995，23（4）：203－214.[PubMed]
[12] Cordeiro PG，Bacilious N，Schantz S，et al. The radial forearm osteocutaneous “sandwich” free flap for reconstruction of the bilateral subtotal maxillectomy defect. Ann Plast Surg，1998，40（4）：397－402.[PubMed]