Nueangkhota Pajjai, Liang Yu-jie, Zheng Guang-sen, Su Yu-xiong, Yang Wei-fa, Liao Gui-qing
Resident, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
Lecturer, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
J Oral Maxillofac Surg. 2016 Apr;74(4):851-9. doi: 10.1016/j.joms.2015.10.013. Epub 2015 Oct 23.
Reconstruction of tongue defects after cancer resection is challenging for reconstructive surgeons. Conventional local flaps are usually compromised in patients with suspected ipsilateral neck metastasis. To extend the application of the nasolabial flap, especially in circumstances in which a free flap is unavailable, the contralateral nasolabial island flap was used, with favorable outcomes.
Seven patients presenting with tongue carcinoma underwent surgical resection and neck dissection. Tongue defects were simultaneously reconstructed using a contralateral nasolabial island flap. Clinical outcomes, including locoregional recurrence and distant metastasis, were recorded. Subjective functional outcomes were investigated using the University of Washington Quality of Life Questionnaire.
All flaps survived without partial or complete necrosis. All patients survived without locoregional recurrence or distant metastasis during follow-up (6 months to 2 years). Functional outcomes were satisfactory, especially swallowing and speech functions. Donor-site morbidity was minimal and the scars were inconspicuously hidden in the nasolabial fold.
The contralateral nasolabial island flap is technically feasible and can be an excellent option for tongue reconstruction without compromising oncologic safety.
对重建外科医生而言，癌症切除术后舌缺损的重建颇具挑战性。对于疑似同侧颈部转移的患者，传统局部皮瓣通常存在缺陷。为扩大鼻唇瓣的应用范围，尤其是在无法采用游离皮瓣的情况下，采用了对侧鼻唇岛状皮瓣，效果良好。
7例舌癌患者接受了手术切除及颈部清扫术。同时采用对侧鼻唇岛状皮瓣重建舌缺损。记录包括局部区域复发和远处转移在内的临床结果。使用华盛顿大学生活质量问卷调查主观功能结果。
所有皮瓣均存活，无部分或完全坏死。所有患者在随访期间（6个月至2年）均存活，无局部区域复发或远处转移。功能结果令人满意，尤其是吞咽和言语功能。供区并发症轻微，瘢痕隐匿于鼻唇沟内不易察觉。
对侧鼻唇岛状皮瓣技术上可行，可成为舌重建的极佳选择，且不影响肿瘤学安全性。
