口腔疾病防治 ›› 2022, Vol. 30 ›› Issue (1): 2-11.DOI: 10.12016/j.issn.2096-1456.2022.01.002

• 专家论坛 • 上一篇    下一篇

面-颏下动脉岛状瓣在口腔颌面部缺损修复中的应用

陈伟良()   

  1. 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:2021-05-04 修回日期:2021-06-18 出版日期:2022-01-20 发布日期:2021-11-04
  • 通讯作者: 陈伟良
  • 作者简介:陈伟良,中山大学名医,二级教授,一级主任医师, 博士生导师,国家重点临床专科(口腔颌面外科)学科带头人,中山大学颅颌面外科中心主任,广东省颅颌面畸形颅面外科矫治技术专家组组长,教育部学位与研究生教育评估专家,国家自然科学基金项目评审专家,国际口腔颌面外科协会会员,国际口腔癌协会会员,美国加州大学(UCLA)客座教授。1983年中山医学院口腔医学系毕业,2005年中山大学岭南(大学)学院高级工商管理班毕业,获h-EMBA学位;1998年与2003年分别在美国加州大学(UCLA)及澳大利亚皇家儿童医院做高级访问学者。 2011年担任广东省医学会颌面-头颈外科学分会主任委员。《Cancer》、《Oral Oncology》、《Head & Neck》、《International Journal of Oral & Maxillofacial Surgery》、《中华医学杂志》、《中国口腔颌面外科杂志》和《口腔疾病防治》等国内外著名杂志的审稿专家。在颅颌面-头颈良恶性肿瘤、脉管疾病、口腔颌面部外伤、颅颌面先天畸形的诊治及软硬组织缺损的修复、功能重建等方面有深入的研究,造诣较深。在内窥镜微创治疗颅底咽旁肿瘤、挽救性治疗侵犯颅底颈动脉的晚期颅颌面-头颈恶性肿瘤以及颈动脉体瘤的治疗方面,取得理想疗效,成果以论文在SCI期刊源上发表。应邀参加分别在美国、澳大利亚、希腊、荷兰、加拿大、英国、巴西、新加坡等国家召开的国际口腔癌学术会议和国际口腔颌面外科大会,并作学术成果报告,同时主持分会场学术活动。主持国家及省部级科研课题15项;以第一和(或)通信作者发表SCI论文120多篇;参编《头颈部血管瘤与脉管畸形 》、《头颈部缺损修复与重建》等专著3部;获广东省人民政府科技成果奖3项;承担本科生教学工作,指导口腔颌面外科硕士研究生50名、博士后和博士研究生30余名。
  • 基金资助:
    国家自然科学基金项目(81772888)

Application of facial-submental artery island flap in reconstruction of oral and maxillofacial defects

CHEN Weiliang()   

  1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
  • Received:2021-05-04 Revised:2021-06-18 Online:2022-01-20 Published:2021-11-04
  • Contact: CHEN Weiliang
  • Supported by:
    grants from general program of Natural Science Foundation of China(81772888)

摘要:

面-颏下动脉岛状皮瓣(facial-submental artery island flap,FSAIF)是由面动脉-颏下动脉供血的筋膜皮瓣,其与口腔颌面部缺损区相邻,其质地、色泽与头面部相似,该瓣血供恒定且血运充分,制备较简单,成活率高,并发症少。根据所携带的组织,FSAIF可分为筋膜皮瓣、肌皮瓣、单纯皮瓣等,该瓣还可制备成带下颌骨的骨筋膜(肌)皮瓣,修复上颌骨缺损。由于其为带蒂瓣,能够大大缩短手术时间、卧床制动时间和住院时间,已被广泛应用于口腔颌面中型缺损修复。医师在使用FSAIF修复口腔颌面部缺损中应严格把握适应证,口腔颌面部良性肿瘤或恶性肿瘤未发生颈淋巴结转移者可安全使用;对于口腔颌面部恶性肿瘤发生颈淋巴结转移但无淋巴结外扩展者,在颈淋巴清扫彻底的前提下可使用该皮瓣。FSAIF修复禁忌证为口腔颌面部恶性肿瘤发生颈淋巴结转移且有淋巴结外扩展,此时,应选择其他组织瓣修复。

关键词: 颏下动脉岛状皮瓣, 面-颏下动脉岛状瓣, 带蒂瓣, 头颈部缺损, 口腔颌面部缺损, 修复重建, 口腔癌, 口咽癌, 唇癌, 颈淋巴结转移, 淋巴结外扩展

Abstract:

The facial submental artery island flap (FSAIF) is a fasciocutaneous flap supplied by the facial submental artery. It is in close proximity with many oral and maxillofacial regions, and its tex ture and color are similar to those of the head and face. The flap has a constant and sufficient blood supply, and it is easy to prepare and has high survival rates and few complications. According to the tissue carried, FSAIF can be divided into fasciocutaneous flaps, myocutaneous flaps and simple flaps. The flap can also be made into an osteofasciocutaneous (myocutaneous) flap with a mandible to repair maxillary defects. Because this flap is a pedicled flap, it can greatly shorten the operation time, bed rest time and hospitalization time and has been widely used in repairing medium-sized defects of the oral and maxillofacial region. The indications for FSAIF in repairing maxillofacial defects should be strictly controlled. It can be safely used for benign or malignant tumors without cervical lymph node metastasis. For malignant tumors with cervical lymph node metastasis but without extranodal extension, the flap can be used on the premise of thorough neck dissection. The contraindication is cervical lymph node metastasis and extranodal extension of malignant tumors; therefore, other flaps should be selected for repair.

Key words: submental artery island flap, facial-submental artery island flap, pedicled flap, head and neck defect, oral and maxillofacial defect, reconstruction, oral carcinoma, oropharyngeal carcinoma, lip carcinoma, cervical lymphnode metastasis, extranodal extension

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