Chow Tam-Lin, Choi Chi-Yee, Ho Lai-In, Fung Siu-Chung
Division of Head and Neck Surgery, Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR, People's Republic of China ; Department of Surgery, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong SAR, People's Republic of China.
Division of Head and Neck Surgery, Department of Surgery, United Christian Hospital, Kowloon, Hong Kong SAR, People's Republic of China.
J Maxillofac Oral Surg. 2014 Mar;13(1):75-7. doi: 10.1007/s12663-013-0477-8. Epub 2013 Jan 29.
Reconstruction of full-thickness buccal defect is challenging as two linings need to be addressed. Either two different flaps or double-paddle for one free flaps are necessary for this defect. The prolonged operation might not be tolerated by patients because of advanced age or medical comorbidity. A 77-year-old gentleman, with significant medical comorbidity, presented with a 4.0 × 4.5 cm ulcerative mass due to squamous cell carcinoma arising from the left buccal mucosa. The tumor extended to the left cheek skin. There was no palpable neck node. CT scan did not show any bony erosion or suspicious neck node. Full-thickness resection of the tumour was undertaken. For the full-thickness buccal defect, a bi-paddled pedicled submental flap after de-epithelialization of the flap skin was used for both the cutaneous and mucosal resurfacing. The flap survived completely and patient recovered smoothly. The surgery is simple and operation time is much shorter than free flap reconstruction. This modified utilization of submental flap simplifies the closure of complicated oro-facial wound.
全层颊部缺损的修复具有挑战性，因为需要处理两个衬里。对于这种缺损，要么需要两个不同的皮瓣，要么需要一个游离皮瓣的双叶瓣。由于患者年龄较大或存在内科合并症，可能无法耐受长时间的手术。一位77岁的男性患者，有明显的内科合并症，因左颊黏膜鳞状细胞癌出现一个4.0×4.5厘米的溃疡性肿块。肿瘤已扩展至左颊皮肤。未触及颈部淋巴结。CT扫描未显示任何骨质侵蚀或可疑的颈部淋巴结。对肿瘤进行了全层切除。对于全层颊部缺损，使用去上皮化的双叶带蒂颏下皮瓣进行皮肤和黏膜的修复。皮瓣完全存活，患者恢复顺利。该手术操作简单，手术时间比游离皮瓣修复短得多。这种改良的颏下皮瓣应用简化了复杂口腔颌面伤口的闭合。
