目的:对伴有淋巴结转移的口腔癌及口咽癌患者采用外侧斜方肌皮瓣修复肿瘤切除后软组织缺损的疗效。方法对6例确诊为口腔癌及口咽癌患者(舌癌2例,颊癌1例,口咽癌2例,口底癌1例,临床分期 T1-4 N1-2 M0),全部行肿瘤切除及根治性颈淋巴清扫术,术中沿颈淋巴清扫下缘切口向外设计外侧斜方肌皮瓣,采用该皮瓣修复肿瘤切除后的软组织缺损。结果所有皮瓣均成活,2例出现边缘少许坏死,经换药处理后愈合;除1例修复舌体患者术后2个月发生皮瓣萎缩外,其余5例在外形和功能上均有不同程度恢复。1例未能按医嘱行术后放疗的患者于术后8个月发生对侧淋巴结转移,其余5例患者术后追加放疗和(或)化疗,随访5~30个月,无复发。结论外侧斜方肌皮瓣是对伴有淋巴结转移的口腔癌或口咽癌患者术后行软组织缺损修复的一种简单而有效的方法。
Objective To evaluate the clinical effects of lateral trapezius myocutaneous flap (LTMF) for repairing tissue defects of oral and oropharyngeal carcinoma after resection .Methods 6 cases including 2 cases of carcinoma of tongue,2 cases of carcinoma of oropharyngeal ,1 case of carcinoma of buccal and 1 case of carcinoma of mouth floor ,TNM stages were classified as T1-4 N1-2 M0 ,and received tumor resection and radical neck dissection .Of all the cases,soft tissue defects caused by oral and oropharyngeal carcinoma resection were repaired with LTMF .Results All lateral trapezius myocutaneous flaps survived except 2 flaps with edge necrosis,which were cured after dressing change .All the patients got different levels of improvement on the recon -struction of appearance and function but 1 flap which repaired the defect of tongue occurred atrophy 2 months after surgery.1 case with tongue carcinoma occurred contralateral cervical lymph node metastasis 8 months after surgery,while no recurrence was found in other cases during 5 ~30 months follow-up.Conclusion LTMF is a simple and useful flap for repairing the soft tissue defects of oral and oropharyngeal carcinoma complicated with cervical lymph node metastasis after resection .