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目的探讨游离皮瓣在全下唇及颏部大范围缺损修复重建中的应用价值及临床效果。方法 2007年7月至2013年3月,对中国医科大学口腔医学院口腔颌面外科收治的12例下唇癌根治术后及2例外伤造成的全下唇及颏部缺损患者,应用前臂皮瓣和股前外侧皮瓣同期修复。术后随访6个月至3年,并对患者修复后下唇外观和功能进行评价。结果 14例皮瓣全部成活,成活率100%。术后随访下唇癌患者肿瘤未见复发,14例患者均可进行基本正常的语言交流;12例可进普食,2例进软食;1例流涎,均无小口畸形。下唇及颏部外观患者均能接受。结论应用游离皮瓣修复全下唇及颏部缺损,方法安全可靠且成功率较高,根据下唇及颏部缺损范围选择合适修复方式可获得较好的口腔功能和外观。
Objective To investigate the value and clinical effect of free flap in the repair and reconstruction of the entire lower lip and chin. Methods From July 2007 to March 2013, 12 cases of lower lip cancer treated by oral and maxillofacial surgery of Stomatology School of China Medical University and 2 cases of total lower lip and chin defect caused by trauma were treated with forearm skin Flaps and anterolateral skin flap repair at the same time. The patients were followed up for 6 months to 3 years, and the appearance and function of the lower lip after repair were evaluated. Results All the 14 flaps survived with 100% survival rate. There was no recurrence of tumor in patients with lip cancer after operation. All 14 patients had basic and normal language communication, 12 cases could be fed with general diet, 2 cases with soft food, and 1 case with salivary gastrectomy. Lower lip and chin appearance patients can accept. Conclusion The application of free skin flap to repair the whole lower lip and chin defects is safe and reliable with high success rate. According to the range of defect of the lower lip and chin, proper repair can be obtained to obtain better oral function and appearance.