岛状颊肌粘膜瓣修复腭瘘的临床研究

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1、岛状颊肌粘膜瓣修复腭痿的临床研究岛状颊肌粘膜瓣修复腭痿的临床研究［摘要］目的:探索应用岛状颊肌粘膜瓣方法修复较大而积腭痿的临床实践，探讨该方法的优缺点。方法：应用蒂在前上的岛状颊肌粘膜瓣修复腭痿4例;应用蒂在后的岛状颊肌粘膜瓣修复腭痿14例，其中有7例在修复腭痿的同时延长软腭以矫正腭咽闭合不全。结果:共修复腭痿患者18例；其屮15例腭部痿孔获得关闭，颊肌黏膜瓣成活良好，无感染、腮腺导管损伤或阻塞、面神经损伤，无张口受限、瘢痕挛缩及咀嚼障碍；2例因岛状颊肌粘膜瓣远端愈合不良再次出现硬腭前端痿口，但面积较原来明显减小，其屮1例再发腭痿应用已转移到腭部的颊肌粘膜瓣组织行二

2、次手术修复后愈合；1例岛状颊肌粘膜瓣部分坏死。结论：应用蒂在前上和蒂在后的岛状颊肌粘膜瓣修复腭痿是一种比较安全可靠的方法，其成活率高，叮以灵活转移修复各个部位的腭痿，在修复软硬腭交界部位腭痿的同时可延长软腭、矫正腭咽闭合不全。即使腭痿再发，可以应用已转移到腭部的肌黏膜瓣修复之。［关键词］腭痿；岛状颊肌粘膜瓣；腭裂［中图分类号1R782.05［文献标识码］A［文章编号11008-6455(2009)03-0302-05AclinicalstudyontheBuccinatorMusculomucosalIslandFlapforPalatalFistulaRepair

3、MATing-ting,ZHAOZhen-min,YINNing-bei,XIONGBin,CHENGTing,WANGChun-yan,WUDi,YANWei,TANGXin,QINYong-ping(TheFirstDepartmentofPlasticSurgeryHospital,ChineseAcademicMedicalScieneeandPekingUnionMedicalCollege,Beijing100144,China)Abstract:ObjectiveToexploreandevaluateclinicalapplicationsofbuc

4、cinatormusculomucosalislandflapforpalatalfistularepair・MethodsThebuccinatormusculomucosalislandflapspedicledsuperior-anteriorlybasedonthedistalportionofthefacialarterythroughtheanteriorbuccalbranchesandpedicledposteriorlybasedonthebuccalarteryandposteriorbranchesofthefacialarterywerede

5、signedforpalatalfistularepair・18palatalfistulaewererepairedbythismethod,4pedicledsuperior-anteriorlyand14pedicledposteriorly,7ofwhichgotvelopharyngealincompetencecorrectionatthesametime・ResultsAllofthepatientsgotsatisfactoryfistulaclosureexcept3complications.Oneflapgotpartlynecrosisand

6、twogotfistulaeatthehardpalate・However,thefistulasizeswerereducedgreatlyandonehasbeenre-repairedwellbythetransferredbuccinatormusculomucosalflaponeyearlater・Allthepatientshadnofacialnervesinjuries,nolimitationinmouthopeningandnomasticationdifficulty.ConclusionThebuccinatormusculomucosal

7、islandflapspedicledsuperior-anteriorlyandposteriorlyaretrustworthyandsafeforpalatalfistularepair・Itcanbetransferredconvenientlytorepairfistulaofanyposition.Theflappedicledposteriorlycanprolongthesoftpalatemeantime,whichishelpfultosomefistulapatientscomplicatedbyvelopharyngealinsuffic