- 期刊
Oromandibular Reconstruction with a Single Double-Paddle Fibular Osteomyocutaneous Flap for an Advanced Double Oral Cancer
雙重口腔癌腫瘤切除後使用單一具有二個皮板的游離腓骨骨肌皮瓣重建口腔及下頜骨
摘要
背景： 對整形重建外科醫師而言，重建口腔癌切除後的複合性組織缺損，常常是一件困難的工作。而何謂最理想的方法，也是時有爭論的。我們提出一個口腔癌經廣泛性切除的病例，使用單一具有二個皮板的游離腓骨骨肌皮瓣來同時重建位於左側舌，右側牙齦及下頜骨的缺損。 目的及目標： 提出一個病患罹患兩處同時存在的口腔癌，經廣泛切除後造成下頷骨及軟組織複合性缺損，使用單一游離腓骨骨肌皮瓣具有二個各自獨立的皮板、肌肉及骨頭來完成重建手術。 材料及方法： 一名51歲男性病患，經診斷同時發現有兩處口腔癌，包括有左側舌部及右側牙齦及下頜骨侵犯，廣泛性切除後造成左側舌部、右下方牙齦及右側下頜骨多處組織缺損。病患接受單一具有二個皮板的游離腓骨骨肌皮瓣來做頭頸部重建。 結果： 術後病患恢復良好，功能性及美觀上預後，也得到不錯的結果。 結論： 單一游離腓骨骨肌皮瓣具有二個各自獨立的皮板、肌肉及骨頭，能同時重建多個部位，是一個施行頭頸部重建的理想方式。此外，捐贈部位併發症少，術後功能性及美觀性預後佳。
關鍵字
無資料並列摘要
Background: Reconstruction of the composite defects after advanced oral cancer surgery is a real task for most plastic surgeons. Controversy still exists about the optimal method for such anatomic defects. Aim and Objectives: We report our experience of using a single free double-paddle fibular osteomyocutaneous flap to simultaneously reconstruct gingiva, tongue, and mandible defects following wide excision for double oral cancer. Materials and Methods: A 51-year-old man had been diagnosed for a double oral cancer with right mandible and left tongue invasion. Wide resection of the tumors resulted in defects over left side of tongue, right lower gingiva, and nearly total loss of right hemi-mandible. We designed a single free double-paddle fibular osteomyocutaneous flap to reconstruct these defects without other additional flap. Result: The patient had well postoperative recovery and gained exciting functional and cosmetic outcomes. Conclusion: Double-paddle fibular flap composed of two separate cutaneous paddles, muscle and bone is an ideal option for oromandibular reconstruction with low donor site morbidity, and results in good postoperative functional and cosmetic outcome.