论文部分内容阅读
作者们报道应用肩胛提肌瓣与裂层皮瓣修复肿瘤病人术后的口、咽缺损区。当行根治性颈廓清术时应记住肩胛提肌血供的三个来源:(1)颈横动脉,当肌瓣向上翻转时血管总是被横切断;(2)颈升动脉来自甲状腺下动脉、甲状颈干或颈横动脉,在应用肌瓣时应注意保护;(3)椎动脉,肌上端血供来自此血管后的小分支。应尽可能保护副神经以维持斜方肌的正常功能和肩胛功能无明显障碍。肌瓣的取法,将肌肉的外侧缘向下分离尽可能暴露达肩胛骨后,在肌下端切断,由下向上游离之,注意颈升动脉分支的保护。肌瓣的最大长度应在向上翻转后恰达下颌前弓,足够口
The authors report the application of the scapular levator muscle flap and the split-layer flap to repair the mouth and pharyngeal defects in patients with tumors. The three sources of scapular levator muscle blood supply should be kept in mind when performing radical neck dissection: (1) cervical transverse artery, the blood vessels are always transected when the muscle flap is flipped upwards; (2) the ascending artery originates from the inferior thyroid artery , Thyroid neck or transverse cervical artery, should pay attention to the protection in the application of muscle flap; (3) vertebral artery, the upper blood supply from the blood vessels after the small branch. Paraspinal nerves should be protected as far as possible to maintain the normal function of trapezius muscles and scapular function without obvious obstacles. Muscle flap method, the lateral separation of the muscles downward as possible exposure to the scapula, the lower end of the muscle cut off, from the next up to the free, pay attention to the protection of the branch of the neck artery. The maximal length of muscle flap should be overturned after the mandibular mandibular arch enough mouth