折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘8例报道

doi:10.19438/j.cjoms.2019.02.014

中国口腔颌面外科杂志 ›› 2019, Vol. 17 ›› Issue (2): 166-170.doi: 10.19438/j.cjoms.2019.02.014

折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘8例报道

周斌, 庄秀妹, 陈伟良, 钟江龙, 陈睿, 王勋明

中山大学附属孙逸仙纪念医院口腔颌面外科,广东广州 510120

收稿日期:2018-07-23 修回日期:2018-10-10 出版日期:2019-03-20 发布日期:2019-04-12
通讯作者: 陈伟良, E-mail：drchen@vip.163.com
作者简介:周斌（1988-）,男,博士,主治医师, E-mail：dophenchou@163.com
基金资助:
国家自然科学基金（81702695,81772888）

Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae after salvage total laryngectomy in 8 consecutive cases

ZHOU Bin, ZHUANG Xiu-mei, CHEN Wei-liang, ZHONG Jiang-long, CHEN Rui, WANG Xun-ming

Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Guangzhou 510120, Guangdong Province, China

Received:2018-07-23 Revised:2018-10-10 Online:2019-03-20 Published:2019-04-12

摘要/Abstract

摘要： 目的:探讨应用折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘的临床效果。方法:8例（男7例,女1例;年龄46~65岁,平均年龄57.6岁）全喉切除术后巨大咽皮瘘患者,咽皮瘘直径2.0 cm×1.8 cm~4.5 cm×3.0 cm,采用折叠延长下斜方肌岛状皮瓣修复。皮岛宽5~9 cm,长10~23 cm,折叠修复咽皮瘘,恢复咽腔内衬里及外侧皮肤。结果:8例皮瓣全部成活,患者无继发咽皮瘘与咽狭窄,吞咽功能满意。结论:折叠延长下斜方肌岛状肌皮瓣可作为修复全喉切除术后巨大咽皮瘘的首选皮瓣,其操作简便,安全可靠。

关键词: 全喉切除术, 咽皮瘘, 斜方肌皮瓣, 带蒂皮瓣

Abstract: PURPOSE: To explore the feasibility of using folded extended vertical lower trapezius island myocutaneous flap(TIMF) for reconstructing large pharyngocutaneous fistulae developing after salvage total laryngectomy. METHODS: Eight （7 males and 1 females, 46 to 65 years of age, with a mean age of 57.6 years) large pharyngocutaneous fistulae, 2.0 cm×1.8 cm-4.5 cm×3.0 cm in size, were reconstructed following salvage total laryngectomy using folded extended vertical lower TIMF. The skin paddle of the extended vertical TIMF flap was 5-9 cm wide and 10-23 cm long. The folded flap provided both inner and outer linings for pharyngocutaneous fistulae. RESULTS: All flaps survived well. No fistula recurrence or stricture developed. Swallowing function was satisfactory. CONCLUSIONS: Folded extended vertical lower TIMF is a large, simple, and reliable flap preferred for reconstructing large pharyngocutaneous fistulae developing after salvage total laryngectomy.

Key words: Total laryngectomy, Pharyngocutaneous fistulae, Trapezius flap, Pedicle flap

中图分类号:

R782.05

周斌, 庄秀妹, 陈伟良, 钟江龙, 陈睿, 王勋明. 折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘8例报道[J]. 中国口腔颌面外科杂志, 2019, 17(2): 166-170.

ZHOU Bin, ZHUANG Xiu-mei, CHEN Wei-liang, ZHONG Jiang-long, CHEN Rui, WANG Xun-ming. Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae after salvage total laryngectomy in 8 consecutive cases[J]. China J Oral Maxillofac Surg, 2019, 17(2): 166-170.

参考文献

[1] Šifrer R, Anicin A, Pohar MP, et al.Pharyngocutaneous fistula: the incidence and the risk factors[J]. Eur Arch Otorhinolaryngol, 2016, 273(10): 3393-3399.
[2] Higgins KM, Ashford B, Erovic BM, et al.Temporoparietal fascia free flap for pharyngeal coverage after salvage total laryngectomy[J]. Laryngoscope, 2012, 122(3): 523-527.
[3] Guimarães AV, Aires FT, Dedivitis RA, et al.Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review[J]. Head Neck, 2016, 38(Suppl 1): E2317-E2321.
[4] Hone R, Rahman E, Wong G, et al.Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis[J]. Eur Arch Otorhinolaryngol, 2017, 274(4): 1983-1991.
[5] Lee DW, Chung S, Lee WJ, et al.Use of a collagen patch for management of pharyngocutaneous fistula after hypopharyngeal reconstruction[J]. J Craniofac Surg, 2010, 21(6): 1674-1676.
[6] Karakullukcu MB, Lohuis PJ, van den Brekel MW, et al. Sealing of small postlaryngectomy pharyngocutaneous fistulas with voice prosthesis[J]. Laryngoscope, 2010, 120(10): 1971-1973.
[7] Loaec E, Vaillant PY, Bonne L, et al.Negative-pressure wound therapy for the treatment of pharyngocutaneous fistula[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2014, 131(6): 351-355.
[8] Demir Z, Velidedeoglu H, Celebioglu S.Repair of pharyngocutaneous fistulas with the submental artery island flap[J]. Plast Reconstr Surg, 2005,115(1): 38-44.
[9] Pabiszczak M, Banaszewski J, Pastusiak T, et al.Supraclavicular artery pedicled flap in reconstruction of pharyngocutaneous fitulas after total laryngectomy[J]. Otolaryngol Pol, 2015, 69(2): 9-13.
[10] Abt NB, Srikanth P, Puram SV, et al.Repair of complex pharyngocutaneous fistula using a staged temporoparietal fascial flap[J]. Am J Otolaryngol, 2017, 38(2): 254-256.
[11] Balakrishnan C, Narasimhan K, Gursel T, et al.Closure of orocutanous fistula using a pedicled expanded deltopectoral flap[J]. Can J Plast Surg, 2008,16(3): 178-180.
[12] Min Yoo W, Suk Pae N, Pio Hong J, et al.Treatment of pharyngocutaneous fistulae with a cork-design radial forearm free flap[J]. J Reconstr Microsurg, 2006, 22(7): 483-487.
[13] Mirghani H, Leymarie N, Amen F, et al.Pharyngotracheal fistula closure using the internal mammary artery perforator island flap[J]. Laryngoscope, 2014, 124(5): 1106-1111.
[14] Sadigh PL, Wu CJ, Feng WJ, et al.New double-layer design for 1-stage repair of orocutaneous and pharyngocutaneous fistulae in patients with postoperative irradiated head and neck cancer[J]. Head Neck, 2016, 38(Suppl 1):E353-E359.
[15] Fink DS, Pena S, Hanby D, et al.Repair of pharyngocutaneous fistula after total laryngectomy: A novel endoscopic approach[J]. Head Neck, 2015,37(7): E81-E84.
[16] Hirano T, Iwasaki T, Fujita K, et al.Repair of a large pharyngocutaneous fistula with a free jejunal patch flap after salvage laryngectomy: A case report[J]. Microsurgery, 2017, 37(1): 61-65.
[17] Chen WL, Wang YY, Zhang DM, et al.Extended vertical lower trapezius island myocutaneous flap versus pectoralis major myocutaneous flap for reconstruction in recurrent oral and oropharyngeal cancer[J]. Head Neck, 2016, 38(Suppl 1): E159-E164.
[18] 黄志权, 王友元, 张丽萍, 等. 以颈横动静脉为蒂的延长锁骨上岛状瓣折叠修复口咽瘘[J]. 中国口腔颌面外科杂志, 2013, 11(4): 329-333.
[19] Huang ZQ, Zhou B, Chen WL, et al.Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae developing after salvage total laryngectomy[J]. Int J Oral Maxillofac Surg, 2018, 47(10): 1268-1273.
[20] Xu ZF, Duan WY, Zhang EJ, et al.Transverse cervical vessels as recipient vessels in oral and maxillofacial microsurgical reconstruction after former operations with or without radiotherapy[J]. World J Surg Oncol, 2015, 13: 183.
[21] Yu P.The transverse cervical vessels as recipient vessels for previously treated head and neck cancer patients[J]. Plast Reconstr Surg, 2005, 115(5): 1253-1258.
[22] Chen W, Yang Z, Zhang D, et al.Second salvage surgery with extended vertical lower trapezius island myocutaneous flap reconstruction for advanced re-recurrent oral and oropharyngeal squamous cell carcinoma[J]. Int J Oral Maxillofac Surg, 2014, 43(5): 531-538.
[23] Chen WL, Yang ZH, Zhou B, et al.Salvage surgery for patients with recurrent oral and oropharyngeal squamous cell carcinoma involving the carotid artery[J]. J Oral Maxillofac Surg, 2016, 74(7): 1483-1493.
[24] Chen WL, Yang ZH, Huang ZQ, et al.Craniofacial resection and reconstruction in patients with recurrent cancer involving the craniomaxillofacial region[J]. J Oral Maxillofac Surg, 2017, 75(3): 622-631.
[25] Gendreau-Lefevre AK, Audet N, Maltais S, et al.Prophylactic pectoralis major muscle flap in prevention of pharyngocutaneous fistula in total laryngectomy after radiotherapy[J]. Head Neck, 2015, 37(9): 1233-1238.
[26] Di Benedetto G, Aquinati A, Balercia P, et al.Supraclavicular island fascial flap in the treatment of progressive hemifacial atrophy[J]. Plast Reconstr Surg, 2008, 121(5): 247e-250e.

折叠延长下斜方肌岛状皮瓣修复全喉切除术后巨大咽皮瘘8例报道

Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae after salvage total laryngectomy in 8 consecutive cases

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