关键词: 斜方肌皮瓣, 肩胛骨肌皮瓣, 颈横血管, 头颈肿瘤, 复发, 挽救性手术, 下颌骨缺损

Abstract: PURPOSE: To evaluate the outcomes of reconstructing through-and-through defects of the mandible. METHODS: The subjects were six patients with recurrent malignant tumors who underwent salvage surgery and reconstruction with combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps based on the transverse cervical vessels (TCVs). RESULTS: All patients had combined bone and extensive soft tissue defects, including four cases of type H, one type LCL and one type C mandible defects and through-and-through soft tissue defects following salvage surgery. All tumors were removed and the complex defects were reconstructed successfully. Two patients experienced minor complications: one minor intraoral flap failure and one case of wound dehiscence at the donor site. None of the patients required nasogastric tube feeding; the appearance of the face and neck was satisfactory or acceptable in all patients. No patient showed severely limited range of motion of the upper limb. The patients were followed for 10 to 18 months. Five patients were alive with no evidence of disease. CONCLUSIONS: The use of combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps based on the TCVs may be an effective approach for reconstructing through-and-through defects of the mandible and may provide satisfactory or acceptable functional and esthetic outcomes following salvage surgery for advanced head and neck tumors.

Key words: Trapezius flap, Scapula flap, Transverse cervical vessels, Head and neck tumor, Recurrence, Salvage surgery, Mandible defect, Oral defect