Tian Hao, Yu Jianjun, Li Zan, Zhou Xiao, Dai Jie
Division of Plastic Surgical Oncology, the Second Department of Head and Neck Surgery, Tumor Hospital Affiliated to Xiangya Medical College of Central South University, Changsha 410043, China. Email:
Division of Plastic Surgical Oncology, the Second Department of Head and Neck Surgery, Tumor Hospital Affiliated to Xiangya Medical College of Central South University, Changsha 410043, China.
Zhonghua Zhong Liu Za Zhi. 2014 Feb;36(2):155-7.
To explore the reconstruction approaches and indications in repairing of postoperative defect after resection of oral floor carcinoma.
To review the clinical data of 106 patients with oral floor carcinoma treated by radical resection with simultaneous reconstruction in the Department of Head and Neck Surgery at our hospital from July 2003 to March 2013, and to evaluate the advantages and disadvantages of various repair methods.
The patients were followed up for 2 months to 10 years. Their 3-year survival rate was 63.6% (42/66) and 5-year survival rate was 57.7% (30/52). One case had sternocleidomastoid myocutaneous flap necrosis, and was successfully repaired with elective pectoralis major myocutaneous flap. Another one case showed partial strap muscle flap necrosis, and the wound was well healed after debridement and dressing changes. Three cases of free flap crisis because of poor blood supply were successfully cured by flap emergency exploration. The rest were well healed. The eating and language function of the patients could meet the general needs of life.
At the time of radical resection of oral floor carcinoma, an appropriate repair method should be selected according to many factors such as disease conditions, defect size, patients' physical constitution, etc. Generally, adjacent pedicle flap is not recommended. Prosthodontics membrane, free forearm flap, free anterolateral thigh flap, pectoralis major myocutaneous flap and free fibula flap can basically meet the need of repair of the postoperative defect after resection of oral floor carcinoma, therefore, are recommended.
探讨口底癌切除术后缺损的修复方法及适应证。
回顾2003年7月至2013年3月我院头颈外科收治的106例口底癌患者行根治性切除同期修复的临床资料，评价各种修复方法的优缺点。
患者随访2个月至10年。3年生存率为63.6%（42/66），5年生存率为57.7%（30/52）。1例胸锁乳突肌肌皮瓣坏死，二期行胸大肌肌皮瓣修复成功。另1例部分带状肌瓣坏死，经清创换药后伤口愈合良好。3例游离皮瓣因血供差出现皮瓣危象，经皮瓣急诊探查治愈。其余患者伤口愈合良好。患者的进食及语言功能可满足生活一般需求。
口底癌根治性切除时，应根据病情、缺损大小、患者体质等多种因素选择合适的修复方法。一般不推荐使用邻位带蒂皮瓣。赝复体膜、游离前臂皮瓣、游离股前外侧皮瓣、胸大肌肌皮瓣及游离腓骨瓣基本能满足口底癌切除术后缺损修复的需要，故推荐使用。
