微血管头颈部重建是一种利用血管重建面部和颈部的技术, bone and tissue, including muscle and skin from other parts of the body. 该技术是修复头颈部肿瘤切除引起的手术缺陷的最先进的手术选择之一.
Microvascular Head and Neck Reconstruction
这项技术包括收集健康组织的皮瓣——在这些组织不那么重要的地方——从身体的偏远部位获得血液供应. The tissue is then transferred to the recipient wound bed, 在重建头颈部的受损区域时，哪里更有用. 用显微镜将皮瓣的血管与颈部血管缝合, allowing the tissue to live as if it were back in its original location.
Conditions treated
微血管头颈部重建用于治疗头颈部癌症, including those of the larynx and pharynx, oral cavity, salivary glands, jaws, calvarium, sinuses, tongue and skin. Cancer treatment usually involves some combination of surgery, 放射治疗和化疗——其中任何一种都可能导致与治疗相关的严重副作用. 头颈癌的治疗会影响面部和颈部的外观, as well as various functions, including: speech, sight, smell, swallowing and taste. 微血管手术用于使头部、面部和颈部尽可能恢复正常.
The technique is also used to treat other conditions including:
- Osteoradionecrosis of the mandible, which is a serious complication of radiation therapy to the head and neck
- Oronasal fistula, which is a hole between the mouth and nose cavity
- Nasal obstruction
- Trismus, which is an involuntary contraction of the mastication muscles
- Velopharyngeal insufficiency, 哪一种疾病会导致说话时腭咽括约肌(口腔软腭肌)关闭不当
- Contour irregularities of the face and neck following surgery
- Non-healing wounds of the head and neck
- Nasal stenosis or deformation following cancer surgery
Preparing for free tissue transfer
If you undergo this treatment, 你需要做很多事情来准备自由组织移植. 如果是作为头颈部恶性肿瘤的治疗, then the procedure will be performed by two surgical teams. 一个小组致力于切除肿瘤和任何可能涉及的淋巴结. And a second team dedicated to reconstruction of the defect.
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在手术之前，你需要与负责两组手术的外科十大赌博平台排行榜见面，你可能需要接受广泛的测试, including: imaging, cardiac and pulmonary testing and possibly tumor mapping and biopsy. 你的病例将在我们的多学科恶性肿瘤委员会和我们整个神经放射学家团队面前展示, medical oncologists, radiation oncologists, surgical oncologists and microvascular reconstructive surgeons, who will compose a comprehensive treatment plan.
The night before treatment
Do not eat or drink after midnight. 在手术前一天和手术当天早上服用常规药物，并加少量水.
Morning of treatment
After the procedure, you may be in the hospital for seven to 10 days. 带上你的药物，如果合适的话，它们可以添加到你的术后治疗中. Slipper-socks and robes are provided. 在候诊区，请随身携带阅读材料、音乐或视频等娱乐用品. 记得把贵重物品，如珠宝和大笔现金留在家里.
确定你知道UCSF的哪家十大赌博平台排行榜会是你手术的地点. An escort will take you to the pre-operative area. A family member or friend may accompany you there. 你会被要求穿上病号服，护士会开始静脉注射(IV)，在手术过程中，你会通过静脉注射液体和轻微的镇静剂. 同样的静脉注射用于成像研究的造影剂.
Procedure
几种类型的微血管重建技术可以使用，包括:
- Free muscle transfer. In this procedure, 外科十大赌博平台排行榜从阔肌(背部)或腹直肌(腹部)切除一块肌肉来重建颅底或颅穹窿. 肌肉在封闭中枢神经系统和促进复杂伤口愈合方面特别有用.
- Free bone transfer. 骨缺损通常是最困难的重建，因为需要精确的骨对齐, as well as cutaneous (skin) coverage. Bone is most commonly used for mandibular reconstruction, 但新的发明允许它用于面部中部和眶上颌重建. 如果腓骨不能移植，另一种选择是阔肌-锯肌-肋骨游离皮瓣. This allows the transfer of an abundant volume of bone, muscle and skin in patients, even with advanced peripheral vascular disease, although the bone quality is not as good when compared with the fibula bone.
- Free skin and free fat transfer. 前臂桡侧皮瓣长期以来一直是用于皮肤覆盖的主要皮瓣. However, 股骨前外侧皮瓣在头颈部重建中应用较多，因为它已被证明是一个理想的供体部位，具有可靠的血管, ease of harvest and versatility. 可以安全地从供体部位获取的组织类型包括:皮肤, skin and fat, fat and fascia or fascia alone. 丰富的可用组织和最低的发病率从这个位置允许重建头颈部轮廓缺陷, pharyngeal reconstruction following laryngectomy, 舌粘膜化重建及鼻内壁及颈部皮肤重建.
这种精确定位大脑的技术被称为立体定向. 立体定向放射外科手术是在成像技术的帮助下进行的 CT Scan, MRI and angiography.
If the reconstruction is targeting your mouth, lower jaw bone, 颈部或咽喉外科十大赌博平台排行榜通常会进行临时气管切开术，以确保你的呼吸安全. 他们也可能放置一个临时喂食管，以确保你在伤口愈合时可以进食.
Recovery
After surgery patients are often sedated for the first night, and awoken the morning following surgery. Patients typically spend two days in the intensive care unit, 然后在普通病房再住5到7天，然后出院. 患者将通过物理治疗进行评估，如果需要广泛的伤口护理或康复需要, 他们可能会被转到康复十大赌博平台排行榜或在家庭护理下出院.
UCSF Health medical specialists have reviewed this information. 它仅用于教育目的，并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.
