Femoral Neuropathy after Reconstruction of a Defect Due to Buccal Cancer Excision Using a Thigh Flap: A Case Report

大腿皮瓣重建口腔癌術後之股神經病變：病例報告

湯依寧(I-Ning Tang) ； 陳若佟(Jo-Tong Chen) ； 洪章仁(Chang-Zern Hong)

《台灣復健醫學雜誌》 33卷3期 (2005/09) Pp. 171-177

https://doi.org/10.6315/2005.33(3)06

摘要

一位口腔癌病人接受局部腫瘤切除合併大腿皮瓣重建術後，併發股神經病變。出現的症狀是取皮瓣側肢體的麻木感及膝蓋伸展無力。理學檢查顯示肌力下降及深層肌腱反射消失。電學檢查顯示患肢股神經的感覺及運動神經傳導速度下降，且股神經支配的肌群有急性去神經化現象產生。此種現象可能是由於在取皮瓣的過程中拉扯到股神經所致。預防的方法是避免在取皮瓣時對股神經做長時間的壓迫。尤其病人體型瘦小時更要注意。

關鍵字

股神經病變 ； 皮瓣 ； 口腔癌

並列摘要

A case of femoral neuropathy as a complication of flap excision for reconstruction of a defect due to buccal cancer excision is presented. A 51-year-old man developed numbness over his left anteromedial thigh and medial lower leg, left quadriceps weakness, and absence of left knee jerk after a flap was obtained from his anterolateral thigh. Electromyographic examination revealed evidence of denervation in the left quadriceps. A nerve conduction study showed prolonged latency, reduced amplitude of the compound muscle action potential, decreased velocity in the left femoral nerve and prolonged latency, reduced amplitude of the sensory nerve action potential, and decreased conduction velocity in the left saphenous nerve. It is suggested that this complication was caused by traction of the femoral nerve when the free antero-lateral fasciocutaneous flap was dissected. The complication may be preventable by avoiding overstretching the femoral nerve during dissection or by application of intraoperational electrodiagnostic monitoring.

並列關鍵字

femoral neuropathy ； flap ； buccal cancer