Oral and Maxillofacial surgery resident, Hospital Universitario Virgen de las nieves, Carretera de Jaen s/n, Hospital de Rehabilitacion y traumatología, 18013 Granada, Spain.
Maxillofacial Surgeon, Hospital Universitario Virgen de las nieves, Carretera de Jaen s/n, Hospital de Rehabilitacion y traumatología, 18013 Granada, Spain.
J Stomatol Oral Maxillofac Surg. 2018 Sep;119(4):284-287. doi: 10.1016/j.jormas.2018.06.006. Epub 2018 Jun 27.
The reconstruction of oral defects after oncological surgery is not an easy task for head and neck surgeons. The main aim of this work is to evaluate the functionality, viability and safety of submental flap for oral reconstruction.
We analyzed the records of patients diagnosed with oral and oropharyngeal SCC and reconstructed with the use of submental flap in Virgen de las Nieves University Hospital of Granada (Spain) from 2014 and 2015. Nine patients were found. Specific features such as age, sites of occurrence, sex distribution, T stage at diagnosis, nodal involvement, functionality of reconstruction and local and regional failure were determined.
The male/female ratio was 8:1. The average age of the patients was 59.6 years (range: 42-75). Tumor locations were base of the tongue (n2), lateral edge of the tongue (n4), floor of the mouth (n2) and buccal mucosa (n1). Six tumors were classified as a T2 tumor and 3 as T3. No major complications were evidenced during the immediate postoperative period. Moreover, all patients showed excellent tissue coverage with acceptable aesthetic and functional outcomes. However, 1 patient showed partial epithelial loss of the skin paleta. Finally, the recurrence rate of disease was 44,4%. Four of 9 patients experienced a local (1/9) or cervical relapse (3/9).
Submental flap might offer great aesthetic and functional results in oral reconstruction. However, the recurrence rate of disease was too high in our sample. From our point of view, submental flap should be carefully indicated in oncological reconstruction, especially in case of suspicion of lymph node involvement at level Ib.
对于头颈部外科医生来说，修复口腔肿瘤手术后的缺损并非易事。本研究的主要目的是评估颏下皮瓣在口腔重建中的功能、存活率和安全性。
我们分析了 2014 年至 2015 年期间在西班牙格拉纳达 Virgen de las Nieves 大学医院使用颏下皮瓣进行口腔和口咽鳞状细胞癌重建的患者记录。共发现 9 例患者。确定了患者的年龄、发生部位、性别分布、诊断时的 T 分期、淋巴结受累情况、重建功能以及局部和区域失败等具体特征。
男女比例为 8:1。患者平均年龄为 59.6 岁（范围：42-75 岁）。肿瘤部位为舌根（n2）、舌侧缘（n4）、口底（n2）和颊黏膜（n1）。6 例肿瘤分类为 T2 期，3 例为 T3 期。术后即刻无明显并发症。此外，所有患者均表现出极好的组织覆盖，具有可接受的美学和功能效果。然而，1 例患者出现皮瓣部分上皮脱落。最终，疾病复发率为 44.4%。9 例患者中有 4 例（1/9）发生局部复发（1/9）或颈部复发（3/9）。
颏下皮瓣在口腔重建中可能提供极好的美学和功能效果。然而，我们的样本中疾病的复发率过高。在我们看来，颏下皮瓣在肿瘤重建中应慎重选择，尤其是在怀疑 Ib 水平有淋巴结受累的情况下。
