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find Author "黄相道" 3 results
  • 胸大肌肌皮瓣修复口腔颌面部恶性肿瘤切除术后缺损

    目的 探讨采用胸大肌肌皮瓣即刻修复口腔颌面部恶性肿瘤切除术后组织缺损的方法、临床经验以及并发症的发生及预防方法2002年1月~2005年12月,对18例口腔颌面部恶性肿瘤术后缺损应用胸大肌肌皮瓣进行即刻修复的效果。其中男13例,女5例;年龄31~77岁。原发疾病组织病理类型均为鳞状细胞癌,其中舌癌12例,口底癌3例,下颌牙龈癌2例,颊癌1例。TNM分类:T2 N0 M0 5例,T2 N1 M0 8例,T2N 2aM0 2例,T3 N1 M0 1例,T3 N2 b M0 1例,T4 N2 bM0 1例。术前化疗3例,疗6例,化疗加放疗2例,未作治疗7例。18例均行根治性颈淋巴清扫术,其中有2例行对侧功能性颈淋巴清扫术。有17例行预防性气管切开术。缺损范围3 cm×3 cm~8 cm×5 cm,制备的胸大肌肌皮瓣范围为5 cm×4 cm~10 cm×6 cm。结果术后16例胸大肌肌皮瓣完全成活,皮瓣无坏死或其他并发症发生;2例皮瓣边缘小部分坏死,出现皮肤口腔瘘,行二期修复治愈。18例获随访1~3年,缺损处外形及吞咽、发音功能恢复良好,肿瘤无复发。结论 胸大肌肌皮瓣成活率高,安全可靠,在口腔颌面部恶性肿瘤手术修复中有较广泛的适应证,并可修复较大面积的缺损。

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • CLINICAL APPLICATION OF ARTIFICIAL CONDYLAR PROCESS FOR RECONSTRUCTING TEMPOROMANDIBULAR JOINT

    【Abstract】 Objective To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Methods Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Results Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. Conclusion The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 游离足背皮瓣修复口腔颌面部恶性肿瘤术后软组织缺损二例

    目的 总结应用足背皮瓣游离移植修复口腔颌面部恶性肿瘤术后软组织缺损的可行性及临床经验。 方 法 2005 年2 月- 2005 年10 月,收治鼻背、面部皮肤鳞状细胞癌及口咽、颊、磨牙后区鳞状细胞癌各1 例。年龄分别为70 岁、69 岁,病程分别为4 年、6 个月,肿瘤分期分别为T3N1M0 和T3N0M0。术中将肿瘤扩大切除,制备9.5 cm ×7.5 cm 和8 cm × 6 cm 大小的带腓浅神经游离足背皮瓣,其血管、神经分别与颈部相应血管及颈部、面部神经吻合。足背部供区取对侧股外侧中厚皮片移植修复。 结果 术后皮瓣均成活,生长良好。颜面及口腔内外形及功能(包括感觉功能)恢复良好。足部供区愈合良好,无功能障碍。患者获2 年随访,肿瘤无复发。 结论 游离足背皮瓣修复口腔颌面部软组织缺损获得较高成功率,既扩展了足背皮瓣的应用范围,又拓宽了口腔颌面部缺损修复方式的选择范围。

    Release date:2016-09-01 09:16 Export PDF Favorites Scan
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