Chen Wei-Liang, Li Jing-Song, Yang Zhao-Hui, Huang Zhi-Quan, Wang Jiang-Uang, Zhang Bin
Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
J Oral Maxillofac Surg. 2008 Jun;66(6):1145-56. doi: 10.1016/j.joms.2007.09.023.
The purpose of this study was to assess the reliability of 2 patterns of submental island flaps--the facial-submental artery island flap and the reverse facial-submental artery island flap--used for reconstruction of oral and maxillofacial defects following cancer ablation.
Thirty-eight soft tissue defects were repaired with facial-submental artery island flaps and reverse facial-submental artery island flaps following cancer surgery. The ages of the patients ranged from 28 to 90 years; 24 were male and 14 were female. The primary lesions included squamous cell carcinoma of the tongue (8 cases), buccal mucosa (16), floor of the mouth (4), lower gingiva (3), oropharynx (2); recurrent squamous cell carcinoma of the palate (3); and basal cell carcinoma of the facial skin (2). The clinical stage of the tumors was stage I in 5 cases, stage II in 25, and stage III in 8. Facial-submental artery island flaps were used in 20 cases, reverse facial-submental artery island flaps in 18. The size of the skin paddle varied from a minimum of 4 cm x 8 cm to a maximum of 5 cm x 15 cm. Direct closure was achieved at all donor sites.
The postoperative outcome for 2 patterns of submental flaps was 36 cases surviving, 2 of complete necrosis, and one other of temporary palsy of the marginal mandibular branch of the facial nerve. The success rate was 95% and 94.4% for the facial-submental artery island flap and the reverse facial-submental artery island flap, respectively. The form and function of recipient sites were well recovered. The donor site leaves a well-hidden scar. The follow-up period was 3 to 24 months, 1 patient died of tumor local recurrences and 2 cases of cervical recurrence were observed.
Two patterns of submental island flaps are safe, rapid, and simple to elevate. The facial-submental artery island flap can reliably be used for reconstruction of the lower and middle thirds of the medium-sized oral and maxillofacial defects and the reverse pattern for reconstruction of the middle and upper thirds of the medium-sized oral and maxillofacial defects.
本研究旨在评估两种颏下岛状皮瓣——面-颏下动脉岛状皮瓣和逆行面-颏下动脉岛状皮瓣——用于癌症切除术后口腔颌面部缺损重建的可靠性。
38例软组织缺损在癌症手术后采用面-颏下动脉岛状皮瓣和逆行面-颏下动脉岛状皮瓣进行修复。患者年龄28至90岁；男性24例，女性14例。原发病变包括舌鳞状细胞癌（8例）、颊黏膜癌（16例）、口底癌（4例）、下牙龈癌（3例）、口咽癌（2例）；腭部复发性鳞状细胞癌（3例）；面部皮肤基底细胞癌（2例）。肿瘤临床分期为Ⅰ期5例，Ⅱ期25例，Ⅲ期8例。采用面-颏下动脉岛状皮瓣20例，逆行面-颏下动脉岛状皮瓣18例。皮瓣大小最小为4 cm×8 cm，最大为5 cm×15 cm。所有供区均直接缝合。
两种颏下皮瓣术后结果为36例存活，2例完全坏死，1例面神经下颌缘支出现暂时性麻痹。面-颏下动脉岛状皮瓣和逆行面-颏下动脉岛状皮瓣的成功率分别为95%和94.4%。受区的形态和功能恢复良好。供区留下隐蔽的瘢痕。随访时间为3至24个月，1例患者死于肿瘤局部复发，观察到2例颈部复发。
两种颏下岛状皮瓣安全、快速且易于掀起。面-颏下动脉岛状皮瓣可可靠地用于中型口腔颌面部中下三分之一缺损的重建，逆行皮瓣用于中型口腔颌面部中上三分之一缺损的重建。
