Microvascular head and neck reconstruction is a technique for rebuilding the face and neck using blood vessels, 骨骼和组织, 包括身体其他部位的肌肉和皮肤. The technique is one of the most advanced surgical options available for rehabilitating surgical defects that are caused by the removal of head and neck tumors.
微血管头颈部重建
This technique involves harvesting flaps of healthy tissue — where the tissue is not as important — with the blood supply from remote sites in the body. 然后将组织转移到受者伤口床上, where it is much more useful in reconstructing the affected area of the head and neck. A microscope is used to suture the blood vessels of the flap to blood vessels in the neck, 让组织像回到原来的位置一样存活.
十大赌博靠谱网络平台处理
Microvascular head and neck reconstruction is used to treat head and neck cancers, 包括喉部和咽部, oral cavity, 唾液腺, jaws, calvarium, sinuses, 舌头和皮肤. 癌症治疗通常包括一些手术的组合, radiation therapy and chemotherapy — any of which can result in significant treatment-related side effects. Treatment of head and neck cancer can affect the appearance of the face and neck, 以及各种功能, 包括:演讲, sight, smell, 吞咽和味觉. Microvascular surgery is used to return the head, face and neck to as close to normal as is possible.
该技术还用于治疗其他疾病，包括:
- 下颌骨放射性骨坏死, 头颈部放射治疗的严重并发症是什么
- 口鼻瘘，是口腔和鼻腔之间的一个洞
- 鼻塞
- 牙关紧闭是咀嚼肌的不自主收缩
- Velopharyngeal不足, which is a disorder resulting in the improper closing of the velopharyngeal sphincter (soft palate muscle in the mouth) during speech
- 手术后面部和颈部轮廓不规则
- 头颈部未愈合的伤口
- 癌症手术后鼻腔狭窄或变形
准备游离组织移植
如果你接受这种治疗, there are many things you will need to do to prepare for a free tissue transfer. 如果是作为头颈部恶性肿瘤的治疗, 然后手术将由两个手术小组进行. One team dedicated to removal of the tumor and any potential involved lymph nodes. 还有一个小组专门修复这个缺陷.
继续阅读
You will need to meet the surgeons in charge of both teams prior to the operation and you may be required to undergo extensive testing, 包括:成像, 心肺检查，可能还有肿瘤定位和活检. Your case will be presented before our multidisciplinary malignant tumor board and our entire team of neuroradiologists, 医疗肿瘤学家, 放射肿瘤学家, 外科肿瘤学家和微血管重建外科十大赌博平台排行榜, 谁来制定一个全面的治疗计划.
治疗前一晚
午夜过后不吃不喝. Take your regular medications the day before and the morning of the procedure with a small amount of water.
治疗早晨
手术后，你可能会在十大赌博平台排行榜呆7到10天. Bring your medications so they can be added to your post-operative regime, if appropriate. 提供拖鞋袜和长袍. Please bring reading materials, music or videos to keep you entertained in the patient waiting area. Remember to leave your valuables, such as jewelry and large sums of cash at home.
Make certain you know which UCSF hospital will be the location for your operation. 有人会带你去术前区. 家人或朋友可以陪你去. You will be asked to put on a hospital gown and a nurse will start an intravenous (IV) line through which you will receive fluids and a mild sedative during the procedure. The same IV is used to administer the contrast agent for your imaging studies.
Procedure
Several types of microvascular reconstruction techniques may be used, including:
- 自由肌肉转移在这个过程中, a surgeon harvests a muscle from the latissimus (back) or rectus abdominus (abdominal region) for reconstruction of the skull base or cranial vault. Muscle is particularly useful for sealing off the central nervous system and for promoting healing of complex wounds.
- 游离骨转移Bony defects are often among the most difficult reconstructions as precise alignment of bone is required, 以及皮肤(皮肤)覆盖. 骨是最常用的下颌骨重建, but new innovation allows its use for midface and orbitomaxillary reconstruction. If the fibula is not available for transfer, another option is the latissimus-serratus-rib free flap. 这允许大量骨的转移, 病人的肌肉和皮肤, 即使是晚期周围血管疾病, 虽然骨质不如腓骨好.
- 自由皮肤和自由脂肪转移The radial forearm has long been the dominant flap used for cutaneous coverage. However, the anterolateral thigh flap is being used more in head and neck reconstruction because it has proven to be an ideal donor site with reliable vascularity, 易于收获和多功能性. Tissue types that may be safely harvested from this donor site include: skin, skin and fat, 脂肪和筋膜或单独筋膜. The abundance of tissue available and the minimal morbidity from this site permits reconstruction of contour defects of the head and neck, 喉切除术后咽重建, mucosalized tongue reconstruction and reconstruction of nasal lining and neck skin.
The technique that allows this precise targeting within the brain is called stereotaxy. Stereotactic radiosurgery is performed with the aid of imaging techniques called CT Scan, MRI 和血管造影术.
如果重建的目标是你的嘴, lower jaw bone, neck or throat surgeons will often perform a temporary tracheotomy to ensure that your breathing will be safe. They may also place a temporary feeding tube to ensure that you may be fed while your wounds heal.
Recovery
手术后患者通常在第一晚服用镇静剂, 手术后的第二天早上醒来. 病人通常在重症监护室呆两天, followed by an additional five to seven days in a regular hospital room before discharge. Patients will be assessed by physical therapy and in the event of extensive wound care or rehabilitation needs, they may be transferred to a rehabilitation hospital or be discharged with home nursing care.
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
