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-  2015 

改良鼻唇沟皮瓣修复前颊部黏膜缺损

DOI: doi:10.7507/1002-1892.20150126

Keywords: 改良鼻唇沟皮瓣, 前颊部, 黏膜缺损, 创面修复

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Abstract:

目的探讨改良鼻唇沟皮瓣修复前颊部黏膜中小型缺损的疗效。 方法2013年3月-2014年4月,收治10例前颊部黏膜病变患者。男8例,女2例;年龄39~62岁,平均47.2岁。左侧4例,右侧6例。口腔白斑3例,白斑恶变3例,口腔扁平苔藓癌变1例,乳头状瘤3例。病程2~15个月,平均7.1个月。病变彻底切除后遗留黏膜和少量颊肌缺损,但未洞穿颊部。缺损宽2.5~4.0 cm、长3.5~5.5 cm,距离口角0.5~1.5 cm。设计蒂部位于口角旁、长轴沿鼻唇沟方向的弯月形改良鼻唇沟皮瓣,自表浅肌肉腱膜系统层面将上、下翼由末端向蒂部掀起,将皮瓣经颊部隧道翻转到达口内用于修复黏膜缺损,口外供区切口直接拉拢缝合。 结果术后鼻唇沟皮瓣均成活,创面Ⅰ期愈合;口外供区切口Ⅰ期愈合。患者均获随访,随访时间6~18个月,平均10.4个月。患者病变无复发,面型对称满意,术侧面部器官无牵拉变形,线性瘢痕无明显增生且隐藏于术侧鼻唇沟内,未见面神经损伤症状,口角形态正常。口裂宽度较术前无明显缩小,末次随访时开口度2.7~3.5 cm,平均3.1 cm。口内皮瓣菲薄平整,与周围黏膜愈合良好,无明显皮瓣挛缩、咬颊和闭口不全等现象发生。 结论改良鼻唇沟皮瓣具有血供可靠、设计灵活、制备简单、供区隐蔽等优点,是修复前颊部黏膜中小型缺损的有效方法之一

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