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目的探讨应用显微外科技术改进颈阔肌皮瓣以修复口腔颌面部缺损的可行性及应用价值。方法以携带肌袖血管蒂的改良颈阔肌皮瓣一期修复口颊部缺损12例,软腭缺损3例,口底缺损1例；同期行颈淋巴结清扫术。结果15例肌皮瓣全部成活,1例肌皮瓣因静脉回流障碍皮瓣远端部分皮肤坏死。修复区手术组织量适中。形态良好,颈部瘢痕不明显。结论应用显微外科技术改良颈阔肌皮瓣不影响血供,肌皮瓣自由度明显改善,适于修复口腔颌面部手术。
Objective To explore the feasibility and application value of using microsurgical technique to improve the repair of oral and maxillofacial defects with platysma myocutaneous flap. Methods A total of 12 cases of cheek defect were repaired with modified platysma myocutaneous flap with myocutaneous pedicled vascular pedicles. There were 3 cases of soft palate defects and 1 case of defect of the floor. The cervical lymph node dissection was performed at the same time. Results All 15 myocutaneous flaps survived, and one of the musculocutaneous flaps was necrotic in the distal part of the skin flap due to venous reflux. The amount of surgical tissue in the repair area is moderate. The shape is good and the neck scar is not obvious. Conclusion The use of microsurgical technique to improve the platysma myocutaneous flap does not affect the blood supply, and the degree of freedom of the myocutaneous flap is significantly improved. It is suitable for the repair of oral maxillofacial surgery.