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目的:比较折叠双皮岛游离前臂皮瓣、腹直肌皮瓣、股前外侧皮瓣和带蒂的胸大肌皮瓣移植修复颊部洞穿缺损的适应症和效果。方法:自2002年2月～2010年6月收治15例口腔颌面部恶性肿瘤患者,肿瘤根治性切除后遗留的颊部洞穿缺损大小范围(包括皮肤和黏膜):32-76 cm2。根据患者的年龄、性别、体型及缺损的部位和大小等情况,分别采用游离前臂皮瓣(3例)、腹直肌皮瓣(4例)、股前外侧皮瓣(2例)或带蒂胸大肌皮瓣(6例)折叠修复,分析和评价修复效果。结果:本组15例随访3个月～7年,除2例胸大肌皮瓣远端小部分坏死外,其余移植皮瓣均成活。面部外形恢复良好,张口不受限。结论:前臂皮瓣较薄,适于修复上颊部或前颊部洞穿缺损,腹直肌皮瓣和胸大肌皮瓣较厚,适于修复伴下颌骨缺损的下颊部和后颊部洞穿缺损,股前外侧皮瓣厚度中等,并可根据需要削薄,适于修复颊部任何区域的洞穿缺损。
OBJECTIVE: To compare the indications and effects of free double-sided island free forearm flap, rectus abdominis flaps, anterolateral thigh flap and pedicled pectoralis major flap in the repair of cheek defect. METHODS: From February 2002 to June 2010, 15 patients with oral and maxillofacial malignancies were treated. The size of defects (including skin and mucosa) in the cheeks left after radical resection was 32-76 cm2. According to the patient’s age, gender, body shape and the location and size of the defect, free forearm flap (3 cases), rectus abdominis flaps (4 cases), anterolateral skin flap (2 cases) or pedicle Pectoralis major muscle flap (6 cases) Folding repair, analysis and evaluation of the repair effect. Results: All the 15 cases were followed up for 3 months to 7 years. Except for 2 cases of pectoralis major myocutaneous flap distal small fractional necrosis, all the remaining flap were survived. Facial shape recovery is good, mouth is not limited. CONCLUSION: The forearm flap is thin and suitable for repairing the defect of the upper cheek or anterior buccal cavity. The flap of the rectus abdominis muscle and the pectoralis major muscle flap are thicker and suitable for repairing the lower cheek and back cheeks with mandibular defects Perforation of the defect, lateral thickness of the anterolateral skin flap, and can be thinning, suitable for repairing any area of the cheek hole wear.