面动脉岛状肌皮瓣修复口腔颌面部组织缺损96例临床分析

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (4): 492-496.

面动脉岛状肌皮瓣修复口腔颌面部组织缺损96例临床分析

王维¹, 潘朝斌², 池宇峰¹, 王佩¹, 谭锡涛¹, 陈勇¹

1.韶关市第一人民医院口腔颌面外科 ,广东韶关 512000; 2.中山大学孙逸仙纪念医院口腔颌面外科, 广东广州 510120

收稿日期:2016-01-08 出版日期:2016-08-25 发布日期:2016-09-06
通讯作者: 潘朝斌,Tel:020-81332429,E-mail:docpcb@126.com
作者简介:王维（1976-）,男,学士,副主任医师,Fax:0751-8875080,
基金资助:
广东省韶关市卫生计生科研计划项目（Y15156）; 广东省韶关市科技计划项目

Clinical study of facial artery island flap for reconstruction of oral and maxillofacial tissue defects in 96 consecutive patients

WANG Wei¹, PAN Chao-bin², CHI Yu-feng¹, WANG Pei¹, TAN Xi-tao¹, CHEN Yong¹

1.Department of Oral Maxillofacial Surgery, the First People,s Hospital of Shaoguan. Shaoguan 512000;
2. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Guangzhou 510120, Guangdong Province, China

Received:2016-01-08 Online:2016-08-25 Published:2016-09-06

摘要/Abstract

摘要： 目的评价应用下颌下区面动脉岛状肌皮瓣修复口腔颌面部组织缺损的临床效果。方法选择2007年3月—2015年8月期间应用下颌下区面动脉岛状肌皮瓣修复96例口腔颌面部组织缺损的临床资料作回顾分析,其中顺行面动脉瓣46例,逆行面动脉瓣50例。观察患者近、远期临床效果,包括受区缺损情况、组织瓣成活情况、外形和功能,以及术后并发症。结果下颌下区面动脉岛状肌皮瓣总成功率为96.9%（93/96）,顺行皮瓣成功率为95.7%（44/46）, 逆行皮瓣成功率为98.0%（49/50）。术后随访0.5~6 a,肌皮瓣受区外观及质地良好,语言及吞咽功能理想,供区瘢痕隐蔽;1例患者出现肿瘤复发;3例出现对侧颈淋巴结转移。结论下颌下区面动脉岛状肌皮瓣可作为颌面部中、小型缺损修复较理想的选择,操作简单易行,其中逆行面动脉岛状肌皮瓣皮瓣不仅可修复颌面部中上1/3的组织缺损,且成活率高,美容效果理想。

关键词: 面动脉, 岛状皮瓣, 缺损, 修复

Abstract: PURPOSE: To evaluate the clinical effect of facial artery island flap for immediate reconstruction of oral and maxillofacial defects. METHODS: From March 2007 to August 2015, the clinical data of 96 patients with facial artery island flap for reconstruction of oral and maxillofacial defects were recorded and analyzed, including 46 patients undergoing anterograde facial artery flap and 50 patients undergoing reversed facial artery flap. The short-term and long-term clinical effect, including receipt site, flap survival, facial appearance and function, and postoperative complications were investigated. RESULTS: The overall success rate for facial artery island flap was 96.9%(93/96), 95.7% for anterograde flap (44/46), and 98.0% for reversed flap (49/50). All patients were followed up for six months to 6 years. The facial appearance and flap texture were satisfied. The speech and swallowing function was ideal. The scar was concealed. One patient had cervical recurrence, three had contralateral cervical lymph node metastasis. CONCLUSIONS: The facial artery island flap of submandibular area can be used to repair maxillofacial defects of medium and small sizes. The operation is simple. The reversed facial artery flap is suitable to repair upper one-third of maxillofacial defect, the survival rate is high and cosmetic outcome is ideal.

Key words: Facial artery, Island flap, Defect, Repair

中图分类号:

R782.2

王维, 潘朝斌, 池宇峰, 王佩, 谭锡涛, 陈勇. 面动脉岛状肌皮瓣修复口腔颌面部组织缺损96例临床分析[J]. 上海口腔医学, 2016, 25(4): 492-496.

WANG Wei, PAN Chao-bin, CHI Yu-feng, WANG Pei, TAN Xi-tao, CHEN Yong. Clinical study of facial artery island flap for reconstruction of oral and maxillofacial tissue defects in 96 consecutive patients[J]. Shanghai Journal of Stomatology, 2016, 25(4): 492-496.

参考文献

[1] Martin D, Pascal JF, Baudet J, et al. The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap [J]. Plast Reconstr Surg, 1993, 92(5): 867-873.
[2] Rojananin S, Igarashi T, Ratanavichitrasin A, et al. Experimental study of the facial artery: relevance to its reverse flow competence and cutaneous blood supply of the neck for clinical use as a new flap [J].Head Neck, 1996, 18(1): 17-23.
[3] Karaçal N, Ambarcioglu O, Topal U, et al. Reverse-flow submental artery flap for periorbital soft tissue and socket reconstruction [J]. Head Neck, 2006, 28(1): 40-45.
[4] 蒋斌, 房敏, 蒋松琪, 等. 颏下岛状皮瓣在头颈外科的应用 [J].上海口腔医学, 2000, 9(4): 194-196.
[5] 赵新, 伍虹, 陈伟良, 等. 去上皮逆行面动脉-颏下动脉颏下岛状瓣修复上颌术后缺损[J]. 中国口腔颌面外科杂志, 2014, 12(1): 61-64.
[6] 赵小朋, 刘军平, 焦九阳, 等. 逆行面动脉瓣修复口腔颌面部肿瘤术后缺损12例报道[J].中国口腔颌面外科杂志, 2012, 10(3): 227-230.
[7] Sebastian P, Thomas S, Varghese BT, et al. The submental island flap for reconstruction of intraoral defects in oral cancer patients [J]. Oral Oncol, 2008, 44(11): 1014-1018.
[8] 陈伟良, 杨朝晖, 黄志权, 等. 逆行面动脉-颏下动脉岛状肌皮瓣修复口腔颌面部缺损的探讨 [J]. 中华口腔医学杂志, 2007, 42(10): 629-630.
[9] 王维, 潘朝斌, 池宇峰, 等. 面动脉岛状肌皮瓣修复舌癌术后组织缺损12例 [J].口腔颌面外科杂志, 2013, 23(1): 54-56.
[10] Magden O, Edizer M, Tayfur V, et al. Anatomic study of the vasculature of the submental artery flap [J]. Plast Reconstr Surg, 2004, 114(7): 1719-1723.
[11] Rojananin S, Igarashi T, Ratanavichitrasin A, et al. Experimental study of the facial artery: relevance to its reverse flow competence and cutaneous blood supply of the neck for clinical use as a new flap [J]. Head Neck, 1996, 18(1): 17-23.
[12] Kim JT, Kim SK, Koshima J, et al. An anatomic study and clinical applications of the reversed submental perforator-based island flap [J]. Plast Reconstr Surg, 2002, 109(7): 2204-2210.
[13] 皮昕.口腔解剖生理学 [M].第3版.北京：人民卫生出版社,1998:121-124.

[1]	陶星如, 张筠, 张佳园, 魏凌飞, 聂萍, 于德栋. 上颌无牙患者种植即刻过渡义齿修复后侧貌软组织的轮廓变化[J]. 上海口腔医学, 2024, 33(4): 373-380.
[2]	张筠, 陶星如, 王凤, 于德栋, 吴轶群. 上颌牙列缺失患者种植支持固定修复前后唇部美学区软组织的变化[J]. 上海口腔医学, 2024, 33(4): 381-386.
[3]	姚旭飞, 蓝博, 季育, 周雪君. 微创环切术对牙列缺损种植患者炎症反应及牙槽嵴顶骨吸收的影响[J]. 上海口腔医学, 2024, 33(4): 398-402.
[4]	贾爽, 王珏, 钟群, 陈骊, 卢汉. PDCA循环带教模式在口腔修复学住院医师规范化培训教学中的应用[J]. 上海口腔医学, 2024, 33(4): 438-442.
[5]	钱叶梅, 王卫红, 朱瑾, 何永静, 许彪, 邹智荣, 施延安, 罗磊, 李静宜. 游离背阔肌皮瓣临床解剖及其在头颈部巨大缺损修复中的应用[J]. 上海口腔医学, 2024, 33(3): 269-272.
[6]	张民珍, 邝惠芳, 杨黎艳, 罗文. 小肠黏膜下层可吸收生物膜在牙槽骨缺损修复中的应用效果评价[J]. 上海口腔医学, 2024, 33(3): 279-284.
[7]	龚志成, 彭艳, 钟群, 邬雪颖, 房硕博. 口内数字印模与选择性压力印模下颌牙列缺损游离端黏膜形态差异分析[J]. 上海口腔医学, 2024, 33(3): 306-311.
[8]	陈宏丽, 尹刚, 张海娟. 阿托伐他汀促进大鼠牙槽骨缺损愈合及对Wnt/β-catenin信号通路的影响[J]. 上海口腔医学, 2024, 33(2): 130-134.
[9]	路茜, 王静, 庞淑婷, 周建营, 冯艳芬, 卢文娟, 张倩. 正畸修复联合疗法对改善深覆伴下前牙严重磨耗患者咀嚼功能的效果评价[J]. 上海口腔医学, 2024, 33(2): 190-194.
[10]	张雪冰, 李琦. PRF负载的Genistein促进肥胖小鼠骨缺损修复的实验研究[J]. 上海口腔医学, 2024, 33(1): 13-21.
[11]	宫汝娟, 何磊. 正畸联合骨水平种植体修复在牙列缺损中的应用效果评价[J]. 上海口腔医学, 2024, 33(1): 76-79.
[12]	赵燕, 张颖, 陈茜, 侯黎莉. 下颌骨缺损患者对咬合功能锻炼需求的质性研究[J]. 上海口腔医学, 2024, 33(1): 106-112.
[13]	张扬, 祝庆海, 张永杰, 王晨星, 叶金海. 血管化髂骨肌瓣的应用解剖学特点及其在颌骨缺损修复中的临床应用[J]. 上海口腔医学, 2023, 32(6): 603-608.
[14]	王静, 路茜, 周建营, 庞淑婷, 冯艳芬, 卢文娟, 张倩. 正畸修复联合治疗内倾型深覆伴重度磨耗患者的效果分析[J]. 上海口腔医学, 2023, 32(6): 656-660.
[15]	王怡婷, 文少敏, 李小红, 李苑荟. 4种口腔修复材料对咀嚼及牙龈功能的影响[J]. 上海口腔医学, 2023, 32(4): 405-409.