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作者按Ariyan术式采用胸大肌皮瓣于头颈部肿瘤手术的器官重建。方法:沿胸大肌外侧或其内数厘米作切口,切开筋膜,以手指分离,掀起肌肉,沿胸部切口内缘放牵开器,常可触得或直接看到神经血管束,作内下或内侧切口,必要时切断结扎胸肩峰动脉和静脉的近端内外侧支以进一步游离该肌皮瓣。还可将胸大肌外侧肌腱部分切断,或在与锁骨下动静脉交界处进一步游离血管神经束以增加肌皮瓣的长度,但切勿损伤血管。游离胸壁内外侧皮肤,一期缝合供皮区创面。共报道9例:1例喉咽切除及颈清扫术后的颈部皮肤缺损,1例腮腺肿块、颧骨切除及颈清扫术后的颊部与颈上部缺损,1例因颈部脓肿及
The authors performed an organ reconstruction of the head and neck tumors using a pectoralis major myocutaneous flap according to the Ariyan technique. Methods: Make a incision along the outside of the pectoralis major muscle or a few centimeters, cut the fascia, separate it with your fingers, lift the muscles, and place the retractor along the inner edge of the chest incision. You can often touch or directly see the neurovascular bundles. A medial or medial incision, if necessary, is performed to sever the proximal and medial branches of the thoracic acromial artery and vein to further dissociate the myocutaneous flap. The pectoralis major muscle can also be severed in the lateral part of the tendon or at the junction with the subclavian artery and vein to further free the vascular nerve bundles to increase the length of the myocutaneous flap but not to damage the vessel. Dissociated the lateral and lateral chest wall skin and sutured the wound area for the first time. A total of 9 cases were reported: 1 case of neck skin defect after laryngopharyngeal resection and neck dissection, 1 case of parotid tumor, cheekbone and neck dissection after cystectomy and neck dissection, and 1 case due to neck abscess and