Lee Jih-Chin, Lai Wen-Sen, Kao Chuan-Hsiang, Hsu Chiang-Hung, Chu Yueng-Hsiang, Lin Yaoh-Shiang
Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Oral Maxillofac Surg. 2013 Oct;71(10):1800-8. doi: 10.1016/j.joms.2013.03.018. Epub 2013 May 3.
The objective of this study was to implement a scoring system to analyze the authors' experience of donor-site morbidity after harvesting a submental flap for the reconstruction of surgical defects at the head and neck region after oncologic resection.
A retrospective case series study was conducted of patients who underwent reconstruction with a submental flap at the Tri-Service General Hospital (Taipei, Taiwan) from 2008 through 2012. Five parameters representing donor-site morbidity (whistling, smiling, neck extension, beard change, and esthetic outcome) were evaluated with a scoring system developed by a blinded panel of 2 clinicians and the patients. Scores were analyzed and compared between patient subgroups.
Twenty-two patients (20 men and 2 women; mean age, 56 yr) underwent reconstruction with a submental flap after head and neck tumor ablation. Primary lesion sites included the oral cavity (13 patients), pharynx (6 patients), larynx (1 patient), neck (1 patient), and sinus (1 patient). The means of all 5 parameters evaluated were higher than 8 on a scale of 0 to 9 (whistling, 8.7; smiling, 8.7; beard change, 8.9; neck extension, 8.2; esthetic outcome, 8.2), showing that submental flap harvesting led to low donor-site morbidity.
Donor-site morbidity after submental flap harvesting was evaluated with a scoring system measuring 5 parameters, namely whistling, smiling, beard change, neck extension, and esthetic outcome. In general, donor-site morbidity was very low. This implemented system and these findings will be helpful in future reconstructive surgical planning and management.
本研究的目的是实施一种评分系统，以分析作者在采用颏下皮瓣修复肿瘤切除术后头颈部手术缺损时供区并发症的经验。
对2008年至2012年在台湾台北三军总医院接受颏下皮瓣修复的患者进行回顾性病例系列研究。由2名临床医生和患者组成的盲法小组开发了一种评分系统，对代表供区并发症的5个参数（吹口哨、微笑、颈部伸展、胡须变化和美学效果）进行评估。对患者亚组的评分进行分析和比较。
22例患者（20例男性，2例女性；平均年龄56岁）在头颈部肿瘤切除术后接受了颏下皮瓣修复。原发病变部位包括口腔（13例）、咽（6例）、喉（1例）、颈部（1例）和鼻窦（1例）。在0至9分的量表上，评估的所有5个参数的平均值均高于8分（吹口哨，8.7分；微笑，8.7分；胡须变化，8.9分；颈部伸展，8.2分；美学效果，8.2分），表明颏下皮瓣切取导致的供区并发症较低。
采用一种测量吹口哨、微笑、胡须变化、颈部伸展和美学效果5个参数的评分系统评估颏下皮瓣切取后的供区并发症。总体而言，供区并发症非常低。这种实施的系统和这些发现将有助于未来的重建手术规划和管理。
