Anatomical study and modified incision of the infrahyoid myocutaneous flap
Anatomical study and modified incision of the infrahyoid myocutaneous flap
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舌骨下肌皮瓣的解剖学研究及改良切口
DOI：
10.1007/s00405-012-2055-y
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发表时间：
2013
影响因子：
2.6
通讯作者：
A. Yang
中科院分区：
文献类型：
--
作者：
D. Ouyang;X. Su;Wei;Yan;Q;A. Yang
皮瓣坏死和颈部功能尤其是旋转功能损伤是舌骨下肌皮瓣临床应用中面临的两个问题。本研究的目的是研究皮板的血管供应和引流，并报告我们改良的皮瓣切口技术。在这项工作中，我们进行了尸体研究，回顾了改良切口的经验并描述了手术过程。我们证实颈阔肌分支为舌骨下肌皮瓣上方的皮板提供营养。颈阔肌分支入口点与其起始点之间的长度测量为 3.38（最小 2.51，最大 4.52）cm。瓣有两个排水系统。皮瓣的皮瓣分别通过颈前静脉和颈外静脉或两者引流。舌骨下肌由甲状腺上静脉引流。早期4例因颈阔肌肌支未得到保护，其中2例出现皮桨坏死。在随后的7例涉及保留颈阔肌分支的病例中，所有皮瓣均成功存活。采用改良切口的患者均获得了令人满意的颈部功能康复和足够的美学效果。我们的结论是，通过仔细保护皮瓣的供应和引流血管，可以降低皮瓣皮板的坏死率。改良切口可以改善术后颈部功能。
Skin paddle necrosis and neck function damage, particularly rotation, are two problems associated with the infrahyoid myocutaneous flap clinical application. The aim of this study was to investigate vessel supply and drainage of the skin paddle and to report our modified flap incision technique. In this work, we conducted a cadaveric study and reviewed our experience with the modified incision and describe the surgical procedure. We confirmed the platysma muscle branch feeds the skin paddle overlying the infrahyoid myocutaneous flap. The length between the platysma muscle branch entry point and its originating point measured 3.38 (min 2.51, max 4.52) cm. The flap has two drainage systems. The skin paddle of the flap was drained by the anterior jugular vein and external jugular vein, respectively, or both. The infrahyoid muscles were drained by the superior thyroid vein. In the early four cases, where the platysma muscle branch was not protected, skin paddle necrosis appeared in two cases. In the later seven cases, which involved preservation of the platysma muscle branch, all flaps successfully survived. Patients in whom a modified incision was used all achieved both satisfactory rehabilitation of neck function and an adequate esthetic result. We conclude that the necrosis rate of the skin paddle of the flap can be reduced by carefully protecting its supply and drainage vessels. The modified incision can improve neck function postoperatively.