延长垂直下斜方肌岛状肌皮瓣修复重建大型头颈部缺损

doi:10.19438/j.cjoms.2023.01.001

摘要/Abstract

摘要： 颈横动脉供血的延长垂直下斜方肌岛状肌皮瓣（extended vertical lower trapezius island myocutaneous flap, eVLTIMF）用于修复重建大型头颈部缺损安全可靠。该瓣制备较简单,成活率高。供区较隐蔽,可直接关闭缝合,并发症少,肩部运动受影响较小;还可制备成折叠瓣,合并其他带蒂瓣或合并肩胛骨骨肌皮瓣修复特大洞穿性缺损或下颌骨缺损。eVLTIMF在头颈部大面积缺损修复,尤其是在晚期复发性头颈部肿瘤挽救手术后巨大缺损修复重建中起着重要作用。本文对斜方肌的临床应用解剖、 eVLTIMF瓣制备及其在颅颌面、口腔颌面和颌颈区缺损修复中的应用作一阐述。

关键词: 斜方肌皮瓣, 肩胛骨瓣, 带蒂瓣, 颈横动脉, 头颈部缺损, 口腔颌面部缺损, 头颈部肿瘤, 口腔癌, 口咽癌, 头颈部重建, 挽救性手术

Abstract: The extended vertical lower trapezius island myocutaneous flap (eVLTIMF) supplied by the transverse cervical artery is safe and reliable for reconstruction of large head and neck defects. The flap is easy to harvest, and the survival rate is high. The donor area is hidden, which can be closed and sutured directly, with fewer complications and less impact on shoulder movement. It can also be made into folded flaps, combined with other pedicled flaps or combined scapular osteomyocutaneous flap was used to repair huge through-and-through defect or defects of the mandible. It is believed that eVLTIMF can play an important role in the repair of large head and neck defects, especially in the repair and reconstruction of huge defects flowing salvage surgery for advanced recurrent head and neck tumors. The clinical applied anatomy of the trapezius muscle, harvesting eVLTIMF flap and application in the reconstruction of craniomaxillofacial, oral maxillofacial and maxillocervical defects were described in this paper.

Key words: Trapezius myocutaneous flap, Scapular flap, Pedicled flap, Transverse cervical artery, Head and neck defects, Oral and maxillofacial defects, Head and neck tumors, Oral carcinoma, Oropharyngeal carcinoma, Head and neck reconstruction, Salvage surgery

中图分类号:

R782.2

陈伟良. 延长垂直下斜方肌岛状肌皮瓣修复重建大型头颈部缺损[J]. 中国口腔颌面外科杂志, 2023, 21(1): 1-10.

CHEN Wei-liang. Reconstruction of large head and neck defects with extended vertical lower trapezius island myocutaneous flap[J]. China J Oral Maxillofac Surg, 2023, 21(1): 1-10.

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