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Anatomical observation and measurement in 50 sides of adult corpses provided reliable data to design of a musculocutaneous flap which consists of the sternal head of the sternocleidomastoid muscle.Since the "marginal branches" of musculo-cutaneousartery are actually the main blood supply of the myocutaneous flap, we design a composite tissue pedicle instead of a muscular pedicle. A technique aiming at protecting the "marginal branch" has been developed, thus the area of the skin flap is expan- ded. As two heads... Anatomical observation and measurement in 50 sides of adult corpses provided reliable data to design of a musculocutaneous flap which consists of the sternal head of the sternocleidomastoid muscle.Since the "marginal branches" of musculo-cutaneousartery are actually the main blood supply of the myocutaneous flap, we design a composite tissue pedicle instead of a muscular pedicle. A technique aiming at protecting the "marginal branch" has been developed, thus the area of the skin flap is expan- ded. As two heads of the sternocleidomastoid muscle can be separated, one head of the muscle is used safely in repairing large defects in the maxillofacial region, and the operation has been successful in 4 cases.This method not only maintains the function of clavicular head of the muscle, preventing the production of postoperative wryneck, but also allows the use of the innervated sternal head of the muscle to repair the loss of the masseter muscle. 本文通过对25具(50侧)成人尸体所进行的解剖学观察与测量,从肌皮动脉“缘支”同样也是肌皮瓣血供主要来源这一新的观点出发,在手术设计上将肌皮瓣的肌蒂改为复合组织蒂,并提出了保护“缘支”的手术操作方法,从而扩大了皮瓣的应用面积。根据胸锁乳突肌两个头的可分离性,手术中安全地切取了单头胸锁乳突肌皮瓣,并用以修复颌面部大块组织缺损获得成功,这不仅保留了胸锁乳突肌锁骨头的功能,防止术后出现“歪颈”,而且有的病例还用胸骨头代替嚼肌,通过保留其运动神经,使已缺损的嚼肌生理功能得到了恢复。 AbstractOn the basis of the anatomical study,theoperating designs and ways of the functionalrepair of the muscle defec ts in the tongue,lip and masseter with the singular sternalhead of sternocleidomastoideus were reported.4l cases (88.24%)of 5l cases were totallysurvived. The advantages of this flap are thatthe tissue quantity iS not so much,the recon-structive operation can be completed in onone-stage,and it is earlier in the functional reco-very of motion and sense. 报道在解剖学研究的基础上,用单头(胸骨头)胸锁乳突肌皮瓣行唇、舌及咬肌区皮肌缺损功能性修复,51例中的皮瓣完全成活率为88.24%。此种肌皮瓣的组织量适中,手术一次完成,其运动和感觉功能恢复较早。 We used pedicled flaps to treat 12 cases in reconstruction after resection ofcarcinoma of parotid gland (including 5 sternocleidomastoid myocutanecus flape,5 greater pectoral muscle island flaps,2 retroauricular flaps), 12 flaps were living well. combined treatment were perfomed in 10 cases.The report described the appliced anatomy and operation method of flaps.The different flaps of operation connected with lymphatic metastasis and defect limitis. 本文总结12例腮腺癌术后组织缺损的修复经验,其中应用胸锁乳突肌皮瓣5例、胸大肌岛状瓣5例、耳后皮瓣2例,12例带蒂皮瓣或肌皮瓣全部成活.10例术后应用放疗或化疗,取得良好效果.作者对各类皮瓣的应用解剖要点和操作进行了讨论.
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