구강암 적출후 경부 도상 피판을 이용한 구강내 결손부의 재건 -3치험례-
THE CERVICAL ISLAND FLAP FOR INTRAORAL RECONSTRUCT10N FOLLOWING EXCISION OF ORAL CANCER -REPORT OF 3 CASES-
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이성근
임종수/김경현/전소연/조영성/신상훈/조영철/성일용/김욱규
KMID : 0360119980200030263
Abstract
요약
이상에서 저자 등은 T의 편평상피 세포암의 3증례에서 적출후 연조직 결손부의 재건을
위해 Tashiro 등에 의해 변형된 Farr등의 경부 도상 피판을 이용하여 술후 특이한 합병증
없이 성공적인 결과를 얻을 수 있었다. 피판 작도시 부피의 한계와 경부 임파절의 전이나
혹은 예방적으로 경부에 3 Gy 이상의 방사선을 투여 받은 환자에서의 사용의 제한점에도
불구하고, 경부도상 피판은 결손 부위에 따른 피판의 다양한 변형이 가능하며, 적출과 동시
에 빠르고 간단하게 효과적으로 결손부를 재건할 수 있으며, 공여부에 대한 피부이식이 필
요하지 않고, 부가적으로 수술 시간과 입원 기간의 단축을 초래해 환자들의 삶의 질을 높일
수 있다고 사료된다.
Many myocutaneous flaps have been used for the reconstruction of intraoral defects
caused defects caused by the excision of oral cancer. Among these myocutaneous flaps,
cervical island flap has been introduced by farr et al. Although different in detail, this
flap was designed as the platysma myocutaneous flap by Futrell et al in the
supraclavicular site. Since many authors applied this flap to cover intraoral defect, they
discussed deeply the blood supply of this flap. To improve further flap survival, it was
modified by Tashiro et al.
This flap makes its vascularity highly reliable. The amount of tissue needed for
reconstruction can be accurately planned. The surgical, and reconstruction procedure can
be performed simply, rapidly, and effectively. Oral functions including deglutition, speech,
and denture fitting are not compromised, With it's minimal deformity, new donor fields
is not necessory. Of course, we keep in mind that this flap has limitations in patients
where much bulk of tissue defects is needed and more than 3000 rad radiation due to
the metastasis of neck lymph node is exposed.
In three patients with intraoral squamous cell
carcinoma(T1-3N0M0), we performed induction
chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer
and peformed reconstruction of intraoral defects with cervical island flap designed by
Tashiro et al. Due to these significant benefits and minimal limitations, we have found
that this flap is adequate for reconstruction of most intraoral defects following cancer
ablation.
키워드
Cervical island flap; Intraoral reconstruction;
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