Sittitrai P, Srivanitchapoom C, Reunmakkaew D, Yata K
Otolaryngology Department, Chiang Mai University Hospital, Chiang Mai 50200, Thailand.
Otolaryngology Unit, Phayao Hospital, Phayao 56000, Thailand.
Br J Oral Maxillofac Surg. 2017 Apr;55(3):251-255. doi: 10.1016/j.bjoms.2016.10.022. Epub 2016 Nov 19.
The submental island flap is useful as an alternative to microvascular free tissue transfer for the reconstruction of defects after resection of oral cancer because it is simple to harvest, reliable, and is associated with good oral function and low morbidity. However, because cancer of the oral cavity carries a risk of level I nodal metastases, the oncological safety of the flap remains controversial. Between April 2012 and September 2016, we studied patients with squamous cell carcinoma of the oral cavity who had surgical resection with submental island flap reconstruction for viability of the flap, signs of recurrence, and complications. Thirty-five patients (22 men and 13 women) were enrolled in the study and the mean (range) duration of follow-up was 23 (11-48) months. Six patients had local recurrences of their tumours, none of which was considered to be related to the flap. No flap was lost completely, but there were 10 cases of partial skin loss that healed with conservative management. There were no orocutaneous fistulas, haematomas, or marginal mandibular nerve palsies. We conclude that the submental island flap can be used safely in selected patients with level I lymph node metastases when the flap has been harvested meticulously.
颏下岛状皮瓣作为口腔癌切除术后缺损重建的一种替代微血管游离组织移植的方法是有用的，因为它易于切取、可靠，并且与良好的口腔功能和低发病率相关。然而，由于口腔癌存在I级淋巴结转移的风险，该皮瓣的肿瘤学安全性仍存在争议。在2012年4月至2016年9月期间，我们研究了接受颏下岛状皮瓣重建手术切除的口腔鳞状细胞癌患者，观察皮瓣的存活情况、复发迹象和并发症。35例患者（22例男性和13例女性）纳入研究，平均随访时间为23（11 - 48）个月。6例患者出现肿瘤局部复发，均认为与皮瓣无关。没有皮瓣完全丢失，但有10例部分皮肤缺损经保守治疗愈合。没有出现口皮瘘、血肿或下颌缘支神经麻痹。我们得出结论，当皮瓣切取精细时，颏下岛状皮瓣可安全用于有I级淋巴结转移的特定患者。
