Shivanand Naveen B, Mohan Mihir T, Joseph Shawn T
Department of Head Neck Surgical Oncology, VPS Lakeshore Hospital, Kochi, Kerala, India.
Craniomaxillofac Trauma Reconstr. 2018 Jun;11(2):157-160. doi: 10.1055/s-0037-1604071. Epub 2017 Jul 21.
Reconstruction of floor of the mouth and ventral surface of the tongue defects can be challenging because inadequate correction can lead to mobility restriction of the tongue and resultant impairment of speech and swallowing. Ideal flap should be pliable, provide adequate bulk, be easy to harvest, and cosmetically acceptable. Commonly used ipsilateral facial artery-based myomucosal flaps may not be ideal if facial vessels need resection. We share our experience in a case of simultaneous primary mucoepidermoid carcinoma of right submandibular and sublingual glands, with a postsurgical defect involving floor of the mouth and ventral surface of the tongue, reconstructed with islanded facial artery myomucosal flap raised from left buccal mucosa and tunneled into the right floor of the mouth defect medial to mandible. The case is being reported to share the method of reconstruction as well as for the rare presentation of simultaneous primary mucoepidermoid carcinoma of multiple major salivary glands.
口腔底部和舌腹面缺损的重建颇具挑战性,因为矫正不足会导致舌头活动受限,进而造成言语和吞咽功能受损。理想的皮瓣应质地柔韧、体积足够、易于切取且美观。如果需要切除面部血管,常用的同侧基于面动脉的肌黏膜皮瓣可能并不理想。我们分享一例同时发生右下颌下腺和舌下腺原发性黏液表皮样癌的病例,术后缺损累及口腔底部和舌腹面,采用从左侧颊黏膜掀起的岛状面动脉肌黏膜皮瓣,经隧道转移至右侧口腔底部下颌骨内侧的缺损处进行重建。报告该病例旨在分享重建方法以及多涎腺同时发生原发性黏液表皮样癌这种罕见表现。