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目的:寻找口腔颌面部缺损的理想修复方法。方法:对97例口腔颌面部缺损,根据缺损部位、性质、范围,分别采用鼻唇沟皮瓣(6例),邻位滑行皮瓣(13例),Abbe瓣(4例),胸大肌肌皮瓣(17例),颈阔肌肌皮瓣(14例),下斜方肌肌皮瓣(4例),前臂皮瓣(13例),额瓣(6例),颞肌筋膜瓣修复(6例),舌瓣(11例),腓骨肌皮瓣(3例),观察修复效果。结果:97例区域组织瓣中,胸大肌肌皮瓣坏死1例,下斜方肌肌皮瓣尖端坏死1例,另1例胸大肌皮瓣术后放疗后坏死(术后4月),其余皮瓣存活,外形基本满意。所有患者均能进食,97%能正常饮食(食饭),其余可流质饮食。舌、腭、咽、口底肿物T3以上,术后语音轻度影响。结论:采用以上多种区域组织瓣修复口腔颌面部缺损,建议应尽可能采用邻近带蒂皮瓣;对于较大缺损修复主要是修复组织缺损,采用不同组织修复缺损,对进食、语音影响似区别不大,日后尚需作深入研究。
Objective: To find an ideal repair method of oral and maxillofacial defects. Methods: A total of 97 cases of oral and maxillofacial defects were treated with nasolabial flap (6 cases), adjacent gliding flap (13 cases), Abbe flap (4 cases) Myocutaneous flap (17 cases), platysma flap (14 cases), lower trapezius myocutaneous flap (4 cases), forearm flap (13 cases), frontal lobe (6 cases), temporal muscle tendons Membrane repair (6 cases), the flap (11 cases), and fibular myocutaneous flap (3 cases). The effect of repair was observed. Results: In 97 cases of regional tissue flap, 1 case of pectoralis major myocutaneous flap necrosis, 1 case of inferior trapezius muscle myocutaneous flap necrosis and 1 case of pectoralis major myocutaneous flap postoperative radiotherapy and necrosis (postoperative 4 months) , The remaining flap survival, shape basically satisfied. All patients can eat, 97% of normal diet (food), the rest can be liquid diet. Tongue, palate, pharynx, mouth tumor T3 above, mild postoperative impact. CONCLUSIONS: Using these multiple regional tissue flaps to repair oral and maxillofacial defects, it is suggested that adjacent pedicle flaps should be used as much as possible. For large defect repair, the defect is mainly repaired, and different tissues are used to repair the defect. Little difference, in the future still need to make in-depth study.