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目的探索供区功能和外观损伤更小的游离股前外侧(anterolateralthigh,ALT)皮瓣修复技术,运用于头颈肿瘤术后缺损。方法2003年12月—2005年5月中国医科院肿瘤医院头颈外科用于头颈部手术缺损修复的游离股前外侧皮瓣8例。头颈部肿瘤手术缺损按受区部位分为口咽侧壁3例,舌活动部2例,颊黏膜、舌根和颅底各1例。结果8例游离ALT皮瓣手术均获成功。供区伤口一期愈合,未发现切口裂开,下肢运动和感觉功能障碍等手术并发症。8例皮瓣的穿支血管类型均为肌皮穿支,皮瓣应用面积为(4~8)cm×(5~10)cm。手术时间5~10h,平均7h。皮瓣切取制作时间65~115min,平均80min。结论游离股前外侧皮瓣具有修复技术可靠、供区部位隐蔽和并发症少等优点,是头颈部缺损修复的理想皮瓣之一。
Objective To explore the technique of anterolateral thigh (ALT) flap repair with less damage to function and appearance of the donor site and apply it to the defect of head and neck tumors. METHODS: From December 2003 to May 2005, 8 cases of free anterolateral femoral flaps were used for head and neck surgery in the Department of Head and Neck Surgery, Cancer Hospital of China Medical University. The surgical defect of the head and neck tumors was divided into 3 cases of oropharyngeal lateral wall according to the affected area, 2 cases of tongue active part, 1 case of buccal mucosa, tongue base and skull base. Results All 8 cases of free ALT flaps were successful. The donor site was healed for the first time and no surgical complications such as incision dehiscence, lower limb movement and sensory dysfunction were found. The type of perforator artery in all 8 flaps was myocutaneous perforator, and the area of flap application was (4~8)cm×(5~10)cm. Operating time 5 ~ 10h, an average of 7h. Flap cutting production time 65 ~ 115min, an average of 80min. Conclusions The free anterolateral thigh flap has the advantages of reliable repair technology, concealed donor site and less complications. It is one of the ideal skin flaps for the repair of head and neck defects.