论文部分内容阅读
目的报道1例应用游离延展上臂外侧皮瓣修复洞穿性颊部缺损的临床效果。方法 2011年2月收治1例53岁右颊中分化鳞状细胞癌男性患者,肿瘤根治及右侧颈淋巴清扫术后遗留洞穿性颊部缺损约5 cm×5 cm。设计以左侧后桡侧副动脉及其伴行静脉为蒂的上臂外侧皮瓣,并扩展至前臂上部,皮瓣切取面积约9 cm×5 cm,延长后蒂长约10 cm,皮瓣折叠后修复软组织缺损。结果患者术后创面Ⅰ期愈合,皮瓣成活。术后病理提示右颈深上淋巴结转移性鳞癌,因此术后1个月接受剂量约60 Gy放射治疗。患者获随访6个月,皮瓣色泽、质地良好,口轮匝肌功能正常,患侧口角无歪斜,张口度约3 cm。左侧上臂无功能障碍,但创面周围3 cm区域仍有麻木感。结论游离延展上臂外侧皮瓣血供可靠,操作简便、安全,是一种修复洞穿性颊部软组织缺损的较好选择。
Objective To report the clinical effect of repairing the penetrating cheek defect by using the free-extending upper lateral arm flap. Methods One male 53 years old with moderately differentiated squamous cell carcinoma of the right cheek admitted to our hospital in February 2011 was about 5 cm × 5 cm after radical resection and left neck dissection. The lateral flap of the upper arm pedicled with the left lateral radial artery and its accompanying vein was designed and extended to the upper part of the forearm. The skin flap was cut off about 9 cm × 5 cm in length and about 10 cm in length. The flap was folded After the repair of soft tissue defects. Results The wounds healed in stage Ⅰ and the flaps survived. Postoperative pathology suggestive of right cervical lymph node metastatic squamous cell carcinoma, so a dose of about 60 Gy after 1 month of radiation therapy. Patients were followed up for 6 months, flap color, texture, orbicularis muscle function is normal, ipsilateral mouth angle without skew, mouth opening about 3 cm. Left upper arm without dysfunction, but the area around the wound 3 cm still numb. CONCLUSION: The free extended upper lateral arm flap is reliable, easy to operate and safe, and it is a better choice to repair the soft tissue defect of the penetrating cheek.