구강내 연조직 암 절제후 상부기조 광경근 근피부 경부 피판을 이용한 구강내 재건에 관한 임상적 연구
A clinical study on superiorly based platysma myocutaneous cervical flap for reconstruction following intraoral soft tissue cancer surgery
박봉욱, 신희석, 변준호, 김종렬,
소속 상세정보
박봉욱 ( Park Bong-Wook ) - 경상대학교 의과대학 구강악안면외과학교실
신희석 ( Shin Hee-Suk ) - 경상대학교 의과대학 재활의학교실
변준호 ( Byun June-Ho ) - 경상대학교 의과대학 구강악안면외과학교실
김종렬 ( Kim Jong-Ryoul ) - 부산대학교 치의학전문대학원 구강악안면외과학교실
KMID : 0360120080300010083
Abstract
The goal of reconstruction following ablative therapy for intraoral cancer is the restoration of form and function to permit a return to activities of daily life. Traditional reconstruction includes split thickness skin grafts, myocutaneous flaps and, more recently, various free flaps. Free flaps provide higher level of functional recovery relative to that seen with other techniques but require the complexity of the technique and microvascular anastomosis and thus, extended surgical time and occasionally a second team for harvesting. The platysma myocutaneous cervical flap is a possible alternative for intraoral reconstruction. It is thin and pliable like the tissue provided by the radial forearm free flap. It can be harvested with enough tissue to close most head and neck ablative defects. There is virtually no donor site morbidity involved. This study evaluated 7 patients affected by intraoral squamous cell carcinoma (SCC). All patients underwent the resection of intraoral SCC with neck dissection and subsequent intraoral reconstruction with the superiorly based platysma myocutaneous cervical flap. Flap-related complications occurred in 3 patients. Adjuvant radiation therapy was performed in 3 patients. Average follow-up was 24.1 months after surgery, with a range of 8 to 42 months. All patients presented self assessment of discomfort associated with intraoral recipient sites and cervical donor sites. However, the neck function measured by two-inclinometer technique was within the normal range during relatively long term follow-up period. Our study concluded that superiorly based platysma myocutaneous cervical flap is good alternative to free flaps, especially for relatively smaller defects and for the defects appropriate for the rotation arc of the flap.
키워드
Superiorly based platysma myocutaneous cervical flap;Oral cancer;Neck dissection
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