Cunha-Gomes Dean, Kavarana Naozer M, Choudhari Charudatta, Rajendraprasad J S, Bhathena Hoshi M, Desai Praful B, Vyas Jeetendra J, Gangwal Sanjay
Departments of Plastic & Reconstructive Surgery and Oncosurgery, Bombay Hospital Medical & Research Centre, Mumbai, India.
Ann Plast Surg. 2003 Sep;51(3):283-9. doi: 10.1097/01.SAP.0000063753.91476.05.
The progression of submucous fibrosis to oral cancer is well established. This condition in an advanced stage causes progressive trismus. Oral cancers associated with severe submucous fibrosis (interincisor distance [IID] < or = 1.5 cm) require bilateral buccal mucosal reconstruction after tumor excision. After wide excision of the tumor, a regional flap is used to reconstruct the buccal mucosal loss on that side. The opposite buccal mucosa, afflicted by advanced submucous fibrosis, is released at the same time to open the mouth and is resurfaced by an ipsilateral, inferiorly based nasolabial flap. This helps to rehabilitate the oral cavity completely and to prevent the recurrence of trismus. In 18 months, 12 patients underwent total reconstruction of intraoral tumors associated with submucous fibrosis. The average preoperative IID was 0.875 cm. All patients had inferiorly based, two-stage nasolabial flaps for submucous fibrosis reconstruction. The average pain-free postoperative IID was 3.13 cm.
口腔黏膜下纤维化进展为口腔癌已得到充分证实。这种疾病在晚期会导致进行性牙关紧闭。与严重口腔黏膜下纤维化（切牙间距离[IID]≤1.5 cm）相关的口腔癌在肿瘤切除后需要进行双侧颊黏膜重建。在广泛切除肿瘤后，使用局部皮瓣修复该侧的颊黏膜缺损。同时，对另一侧受晚期口腔黏膜下纤维化影响的颊黏膜进行松解以开口，并通过同侧的低位鼻唇沟皮瓣进行覆盖。这有助于完全修复口腔并防止牙关紧闭复发。在18个月内，12例患者接受了与口腔黏膜下纤维化相关的口腔肿瘤全修复。术前平均IID为0.875 cm。所有患者均采用低位二期鼻唇沟皮瓣进行口腔黏膜下纤维化修复。术后无痛平均IID为3.13 cm。
