各種皮弁による口腔・顎・顔面欠損の再建と臨床経過に関する検討

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Reconstruction using various pedicled flaps for oromaxillofacial defects makes a patients return to social life easier and contributes to the improvement in therapeutic results especially in malignant tumors. In the past 6 years from 1978 to 1984, a review of 35 patients where these flaps were used is as follows: 1) Deltopectoral flaps with or without the transplanted bone for secondary reconstraction of 10 cheeks and 2 mandibular defects required long terms because of the delay transferring the baps, but there was less operative invasion. 2) Major pectoralis myocutaneous flaps for 14 immediate reconstructions of the tongue, floor of mouth, oropharynx and mandible were effective in the repair of soft tissue defect, but not always successful in reconstruction using osteomyocutaneous flaps with the rib or sternum for mandibular defects. 3) In the 2 adult males, the scalp-forehead flaps for immediate reconstruction of the entire upper lip were cosmetically used to make a mustache using the hair-bearing scalp. 4) Flaps of 2 sternocleidomastoids and 5 cervical island skins for immediate reconstruction of the moderate defect in the tongue, floor of mouth and alveolus were taken at the time of neck dissection. However, some flaps caused a postoperative necrosis because of excessive tention due to suturing of the wound and insufficient blood supply, different in previous other flaps. Reconstruction using the above-mentioned flaps was indicated in large and moderate defects. Survival rate of patients with tumor resection from one to five years was as follows; 81.1% in 11 deltopectoral flaps, 57.1% in 14 pectoralis major myocutaneous flaps and 100% in 9 other flaps.

各種皮弁による口腔・顎・顔面欠損の再建と臨床経過に関する検討

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