Objective: To assess the efficacy of supraclavicular artery island flap (SCAIF) for the reconstruction of hypopharynx and upper esophagus. Methods: The SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in (4-8) cm×(5-12) cm. Clinical indexes such as harvesting time and survival were recorded. Results: Harvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications. Conclusions: SCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.
目的: 探索锁骨上岛状皮瓣在修复下咽及食管上段恶性肿瘤术后缺损中的临床应用。 方法: 回顾性分析2015年12月至2017年6月中山大学附属第一医院耳鼻咽喉科医院应用带蒂锁骨上岛状皮瓣修复头颈部肿瘤手术缺损10例患者的病例资料,其中下咽癌食管上段缺损修复8例,下咽平滑肌肉瘤咽后壁缺损修复1例,颈部皮肤缺损修复1例。取锁骨上岛状皮瓣修复缺损(无需血管吻合),皮瓣面积(4~8)cm×(5~12)cm。记录皮瓣切取时间,皮瓣存活情况及供区情况。 结果: 10例锁骨上岛状皮瓣切取时间20~30 min,平均26 min。10例患者中9例皮瓣全部存活,1例皮瓣发生部分坏死合并咽瘘。供区缺损均直接拉拢缝合,无伤口感染及功能损伤等并发症。 结论: 锁骨上岛状皮瓣具有制备技术简单,修复缺损可靠,美观,无局部功能损伤,无需显微血管吻合等优点,可用于下咽及食管上段恶性肿瘤术后的缺损修复。.
Keywords: Head and neck cancer; Reconstructive surgery; Surgical flap.