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原创 颏下岛状皮瓣重建下咽肿瘤切除后非环周缺损

刘良发 主任医师 北京友谊医院 耳鼻咽喉头颈外科
2013-10-11 228人已读
刘良发 主任医师
北京友谊医院

Reconstruction of hypopharyngeal non-circumferential defects with a submental island flap after hypopharyngeal carcinoma ablation.首都医科大学附属北京友谊医院耳鼻咽喉头颈外科刘良发

 

Liangfa Liu, Yanli Liu, Yanlin Wang, Yueying Ma, Jiandong Zhao

 

 

Abstract:

Objective: To study the effects of reconstruction of hypopharyngeal non-circumferential defects with a submental island flap after hypopharyngeal carcinoma ablation. Methods: The charts of eight patients who had stage III-IV hypopharyngeal cancer and who under-went pharyngeal reconstruction with a submental flap, operated upon, between 2011 and 2012 were reviewed retrospectively. All reconstructions were performed by a single surgeon. Surgical procedures, effects and complications were analyzed. Result: All of the donor site defects were closed primarily without any difficulties. None of patient developed a pharyngocutaneous fistula postoperatively. The function of the marginal mandibular nerve was intact in all of the patients postoperatively. There were no perioperative mortalities, and there were no observed flap complications. The donor site healed well and the donor site esthetic outcome was acceptable in all patients. All patients had decannulation of the nasogastric tube in 2 weeks postoperatively. Six patients with partial laryngopharyngectomy had decannulation of the tracheal tube in 2 months postoperatively after completion of the radiotherapy. Three months postoperatively, X-ray barium meal radiography did not show any stricture or stenosis in any of the patients without any sign of aspiration. Among six patients with partial laryngopharyngectomy, 2 patients with pyrifom sinus carcinoma had left persistent hoarseness caused by ipsilateral vocal cord paralysis, 4 patients with posterior hypopharyngeal wall carcinoma had a normal voice with good motility of the vocal cords. Two patients suffered loco-regional recurrence 6 months postoperatively. Conclusion: The submental flap is a very applicable option for reconstructing moderately sized non-circumferential hypopharyngeal defects after hypopharyngeal carcinoma ablation.

 

Key Words: submental island flap, hypopharyngeal carcinoma, reconstruction

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刘良发 主任医师

北京友谊医院 耳鼻咽喉头颈外科

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