颈阔肌皮瓣在下咽癌术后缺损修复中的应用

孙臻峰; 王国良; 刘钰莹; 丁健; 罗丹; 董频

doi:10.13201/j.issn.1001-1781.2017.23.005

颈阔肌皮瓣在下咽癌术后缺损修复中的应用

- 上海市第一人民医院耳鼻咽喉头颈外科(上海, 200080)

详细信息

通讯作者: 董频, E-mail:dongpin64@aliyun.com

中图分类号: R739.63

收稿日期: 2017-08-06

Platysma myocutaneous flaps in reconstruction of defects caused by hypopharyngeal cancer resection

- Department of Otorhinolaryngology Head and Neck Surgery, the First People's Hospital Affiliated to Jiaotong University in Shanghai, Shanghai, 200080, China

More Information

Corresponding author: DONG Pin, E-mail: dongpin64@aliyun.com

Received Date: 06 August 2017

摘要

摘要: 目的: 探讨颈阔肌皮瓣修复下咽癌术后组织缺损的方法及可行性。方法: 应用颈阔肌皮瓣对12例下咽癌术后软组织缺损的患者进行修复。所有患者术前均行2次诱导化疗,并进行了保留喉功能的下咽癌手术和颈部淋巴结清扫术。结果: 12例患者皮瓣全部存活。术后3周所有患者经口进食,无咽瘘,均有咽部异物感,但无吞咽困难。其中3例术后呛咳明显,训练后好转。术后均接受放疗,皮瓣无继发坏死。所有患者均保留了喉功能,除1例外其余都已拔管。结论: 术前对下咽癌患者进行诱导化疗可有效缩小病灶。颈阔肌皮瓣血运丰富,抗感染力较强,成活率高,是修复下咽组织缺损行之有效的方法,手术方法简便,值得推广。
- 下咽肿瘤 /
- 诱导化疗 /
- 颈阔肌皮瓣
Abstract: Objective: To study the method and feasibility in reconstruction of platysma myocutaneous flap of defects caused by hypopharyngeal cancer resection.Method: Twelve cases underwent reconstruction with the platysma myocutaneous flap of hypopharyngeal soft defect were investigated. All cases received 2 times preoperative induction chemotherapy followed by hypopharyngeal cancer resection with laryngeal function preservation and the neck lymph node dissection. Platysma myocutaneous flap was used to repair the hypopharyngeal soft tissue defect.Result: All the flaps survived. Three weeks after surgery, all patients can eat without pharyngeal fistula and dysphagia, but pharyngeal foreign body sensation. Three cases of cough after surgery, improved after training. After postoperative radiotherapy, flap survived without secondary necrosis. Laryngeal function of all cases was retained, and only one case with cannula maintained.Conclusion: Preoperative induction program can effectively reduce the lesion. The placenta myocutaneous flap has rich blood supply, strong anti-infectivity. It is an effective method to repair the hypopharyngeal tissue defect with the placenta myocutaneous flap.
- hypopharyngeal neoplasms /
- induction chemotherapy /
- platysma myocutaneous flap

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参考文献(8)

[1]	ARGIRIS A, KARAMOUZIS M V, RABEO D, et al.Head and neck cancer[J].Lancet, 2008, 371:1695-1709.
[2]	曾威, 卢文辉, 张志利, 等.颈阔肌皮瓣在颊癌术后缺损修复中的应用[J].口腔疾病防治, 2016, 24 (6):345-348.
[3]	RAMANUJAM S, VENKATACHALAM S, SUBRAMANIYAN M, et al.Platysma myocutaneous flap for reconstruction of intraoral defects following excision of oral sub mucous fibrosis:A report of 10cases[J].J Pharm Bioallied Sci, 2015, 7 (Suppl 2):S708-S711.
[4]	LEFEBVRE J L, ANDRY G, CHEVALIER D, et al.Laryngeal preservation with induction chemotherapy for hypopharyngeal squamous cell carcinoma:10-years results of EORTC trial 24891[J].Ann Oncol, 2012, 23:2708-2714.
[5]	张欣欣, 王嘉陵, 武文明, 等.非手术综合治疗保留中晚期下咽癌患者喉器官的临床研究[J].中华耳鼻咽喉头颈外科杂志, 2014, 49 (7):558-563.
[6]	SUNTHARALINGAM M, KWOK Y, GOLOUBEVA O, et al.Phase II study evaluating the addition of cetuximab to the concurrent delivery of weekly carboplatin, paclitaxel, and daily radiotherapy for patients with locally advanced squamous cell carcinomas of the head and neck[J].Int J Radiat Oncol Biol Phys, 2012, 82:1845-1850.
[7]	程晓兵, 马秦, 杨耀武, 等.改良式颈阔肌肌皮瓣在口腔内软组织缺损修复中的应用探讨[J].口腔医学研究, 2010, 26 (2):253-255.
[8]	ANDRE M.ECKARDT.Platysma myocutaneous flapits current role in reconstructive surgery of oral soft tissue defects[J].J Korean Assoc Oral Maxillofac Surg, 2013, 39:3-8.