Li Zhen-ning, Li Rui-wu, Liu Fa-yu, Fang Qi-gen, Zhang Xu, Sun Chang-fu
World J Surg Oncol. 2013 Jul 24;11:165. doi: 10.1186/1477-7819-11-165.
Platysma myocutaneous flap (PMF) is a generally used technique for defect reconstruction after an oral cancer resection. The aim of the study is to present our experience using vertical PMF that sacrificed the facial artery and vein for intraoral reconstruction.
A retrospective review of the medical records of 54 patients who underwent vertical PMF that sacrificed the facial artery and vein for intraoral reconstruction was performed. A comparison between PMF that sacrificed and that preserved the facial vessels was made, and we also compared PMF that sacrificed the facial vessels with radial forearm free flap (RFFF). Statistics concerning the patients' clinical factors were gathered.
The mean age of the 54 patients who underwent PMF that sacrificed the facial artery and vein was 62.0 ± 10.98 years. The co-morbid disease rate of PMF was 53.7%. The flap size ranged from 12 × 5.5 cm to 7 × 5 cm. Survival of the flap was found in all of the cases, with partial necrosis in four cases (7.4%) and total loss in none of the cases. The operation time was 5.7 ± 1.17 h. The complication and success rates were 27.8% and 92.6%, respectively. The 3-year and 5-year survival rates were 77.8% (21/27) and 69.23% (9/13), respectively. The majority of the patients (87.0%) in our series were satisfied with the results of the surgery. There was no significant difference between PMF that sacrificed or that preserved the facial vessels, both in success rate (P = 1) or complication rate (P = 0.72). The patients in the PMF group were older than the patients in the RFFF group (P = 0.011), the operation time was shorter (P < 0.001), and the co-morbid disease rate was higher (P = 0.002). Although the complication rate of PMF (15/54, 27.8%) was higher than that of RFFF (2/34, 5.9%) (P = 0.011), their success rates were similar (92.6%, 94.1%) (P = 1.00).
Vertical PMF that sacrifices the facial artery and vein has specific advantages including in ease preparation and limitations. This technique may provide an effective method for intraoral reconstruction. Our experience in handling the flap may contribute to the success rate.
颈阔肌肌皮瓣（PMF）是口腔癌切除术后缺损重建常用的技术。本研究旨在介绍我们使用牺牲面动脉和面静脉的垂直PMF进行口内重建的经验。
对54例行牺牲面动脉和面静脉的垂直PMF口内重建患者的病历进行回顾性分析。对牺牲面血管与保留面血管的PMF进行比较，同时将牺牲面血管的PMF与桡侧前臂游离皮瓣（RFFF）进行比较。收集患者的临床因素统计数据。
54例行牺牲面动脉和面静脉的PMF患者的平均年龄为62.0±10.98岁。PMF患者的合并症发生率为53.7%。皮瓣大小范围为12×5.5 cm至7×5 cm。所有病例皮瓣均存活，4例（7.4%）部分坏死，无完全坏死病例。手术时间为5.7±1.17小时。并发症发生率和成功率分别为27.8%和92.6%。3年和5年生存率分别为77.8%（21/27）和69.23%（9/13）。本系列中的大多数患者（87.0%）对手术结果满意。牺牲面血管与保留面血管的PMF在成功率（P = 1）或并发症发生率（P = 0.72）方面无显著差异。PMF组患者比RFFF组患者年龄大（P = 0.011），手术时间短（P < 0.001），合并症发生率高（P = 0.002）。虽然PMF的并发症发生率（15/54，27.8%）高于RFFF（2/34，5.9%）（P = 0.011），但其成功率相似（92.6%，94.1%）（P = 1.00）。
牺牲面动脉和面静脉的垂直PMF具有包括易于制备和局限性在内的特定优势。该技术可为口内重建提供一种有效方法。我们处理皮瓣的经验可能有助于提高成功率。
