摘要： 目的：评价面动脉-颏下动脉肌皮瓣修复口腔腭部恶性肿瘤术后组织缺损的临床效果。方法：2008-01—2010-09，采用面动脉-颏下动脉供血的岛状肌皮瓣修复腭部恶性肿瘤术后组织缺损共13例，其中男性7例，女性6例，年龄21~75岁，平均年龄56岁。病理类型：高分化鳞癌7例，中分化鳞癌2例，黏液表皮样癌3例，腺样囊性癌1例。TNM分期：T1N0M0 4例，T2N0M0 6例，T3N0M0 3例。皮瓣大小为（6 cm×4 cm）～（12 cm×5 cm）。其中8例为腭部洞穿性缺损，5例缺损鼻腔侧黏膜尚完整。结果：13例面动脉-颏下动脉供血的岛状肌皮瓣全部成活，患者腭部、颈部创面均一期愈合,腭部缺损修复形态良好。语音、咀嚼、吞咽功能恢复良好，无张口受限、头部后仰受限及面瘫等继发功能障碍，颌面部无明显畸形。3例腭部洞穿性缺损修复患者术后初期出现鼻塞症状，3个月后症状逐渐缓解。术后随访2～3年，未见肿瘤复发及转移。结论：面动脉-颏下动脉供血的颏下岛状肌皮瓣血供明确可靠、制备方便，适宜修复腭部恶性肿瘤术后的组织缺损。

关键词: 面动脉；  , 颏下动脉；  , 岛状肌皮瓣；  , 腭部恶性肿瘤；  , 组织缺损

Abstract: Objective:  To evaluate the clinical outcomes of submental myocutaneous island flap for repairing palate defects following malignant tumor ablation. Methods: Clinical data of 13 cases were retrospectively reviewed. Among them,7 patients were males and 6 were females; the age ranged from 21 to 75 years with an average of 56 years. Pathological diagnosis: highly differentiated OSCC in 7 cases; moderately  differentiated OSCC in 2 cases; 3 cases were mucoepidermoid carcinoma, 1 case was adenoid cystic carcinoma. Four patients were classified as T1N0M0, six as T2N0M0, three as T3N0M0. The sizes of the restoration flaps ranged from 6 cm × 4 cm to 12 cm × 5 cm. The penetrating defects of the palate demonstrated in 8 cases, and the nasal mucosa kept intact in other 5 cases. Results: The island flaps survived well, the surgical incision of palate and neck healed by first intention. The functions of pronunciation, chewing, as well as swallowing were satisfied. There were no limitation of mouth opening or head backward movement. 3 cases suffered from symptoms of nasal congestion in the early stages after grafting and eased up gradually within 3 months. All patients were followed up 2 to 3 years, and no recurrence or metestasis was encountered. Conclusion: The facial artery-submental artery island myocutaneous flap is a flap with reliable blood supply and convenient to prepare. It is suitable to repair the palate tissue defects following  malignant tumor ablation.

Key words: facial artery; , submental artery; , island myocutaneous flap; , malignant tumor of palate; , tissue defect

中图分类号: 

• R739.83

• R782.2