以胸鎖乳突肌－鎖骨肌骨皮瓣重建口腔癌術後缺損病例報告及文獻回顧

本文所舉病例為一名患有右下齒齦鱗狀上皮細胞癌的七十歲男性，以胸鎖乳突肌－鎖骨肌骨皮瓣進行下顎骨及口腔上皮重建，並回顧相關文獻，發現只要能把握以下原則：（1）上甲狀腺動靜脈的保留；（2）慎選下顎缺損處的位置與大小；（3）剩餘鎖骨結構的強化與照護；（4）術前針對腫瘤頸部淋巴結轉移的完善評估，就能增加皮瓣之存活與成功率。另外我們亦提出臨床上的延伸改良，例如（1）保留副神經以維持保存肩部提升功能；（2）保留外頸靜脈提供皮瓣額外之靜脈血液回流，增加皮瓣存活率；（3）保留大耳神經以保存耳部之神經感覺，使胸鎖乳突肌－鎖骨肌骨皮瓣成為手術者另一種更簡單的重建選擇。

關鍵字

胸鎖乳突肌－鎖骨肌骨皮瓣；上甲狀腺動脈；口腔鱗狀上皮細胞癌；鎖骨

並列摘要

We present a seventy-years-old male case with squamous cell carcinoma of right lower gingival reconstructed with Sternocleidomastoid-clavicle (SCM-C) myocutaneous flap. We also review the related literatures and find out if we can follow the principles: (1) preserve superior thyroid arteriovenous system; (2) carefully select the location and size of bony defect; (3) strengthen the remaining structure of clavicle if necessary; (4) evaluate cervical lymph node status before surgery, increased flap survival and success rate can be obtained. We also propose extended modifications to provide clinical improvement, such as (1) preserve accessory nerve to keep shoulder lifting function; (2) preserve external jugular vein to provide additional venous blood return and increase flap survival rate; (3) preserve great auricular nerve to keep auricle sensory. In short, the use of sternocleidomastoid-clavicle (SCM-C) myocutaneous flap will be able to provide another simple choice for oral cavity defect reconstruction.

並列關鍵字

sternocleidomastoid-clavicle (SCM-C) myocutaneous flap ； superior thyroid artery ； oral squamous cell carcinoma ； clavicle

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以胸鎖乳突肌－鎖骨肌骨皮瓣重建口腔癌術後缺損病例報告及文獻回顧

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