Karimi Ebrahim, Badiei Reza, Aghazadeh Keivan, Sohrabpour Saeed, Yazdani Nasrin, Dabiri Sasan
Otorhinolaryngology Research Center, Department of Otorhinolaryngology, Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Craniofac Surg. 2018 Oct;29(7):1821-1824. doi: 10.1097/SCS.0000000000005041.
The submental island flap is a new alternative to the reconstruction of various head and neck defects. But there has been a relative paucity of information about the use of this flap in irradiated patients. The authors present their preliminary experience in the use of this flap in irradiated and nonirradiated patients. Eighty-one patients (53 nonirradiated and 28 irradiated patients) underwent reconstruction with the submental island flap between March 2011 and August 2017. The authors have 13 patients of venous congestion (7 in nonirradiated and 6 in irradiated group), 7 patients of partial necrosis of the flap (4 in nonirradiated and 3 in irradiated group). The authors also have 3 patients of transient paralysis of marginal mandibular nerve (2 in the nonirradiated and 1 in irradiated group), and 2 patients of pharyngo-cutaneous fistula in nonirradiated group. The authors have no cases of total flap loss, permanent paralysis of marginal mandibular nerve but have dehiscence of the submental area after harvesting the flap in an irradiated patient. When combined with the reported experience of other surgeons, the authors' preliminary experience showed that the submental island flap was an excellent alternative in the reconstruction of head and neck defects in both irradiated and nonirradiated patients because of its reliability, versatility, and relatively acceptable complications.
颏下岛状皮瓣是修复各种头颈部缺损的一种新选择。但关于该皮瓣在放疗患者中的应用，相关信息相对较少。作者介绍了他们在放疗患者和未放疗患者中应用该皮瓣的初步经验。2011年3月至2017年8月期间，81例患者（53例未放疗患者和28例放疗患者）接受了颏下岛状皮瓣修复。作者遇到13例静脉淤血患者（未放疗组7例，放疗组6例），7例皮瓣部分坏死患者（未放疗组4例，放疗组3例）。作者还遇到3例下颌缘支神经短暂性麻痹患者（未放疗组2例，放疗组1例），未放疗组有2例咽皮肤瘘患者。作者没有出现皮瓣完全坏死、下颌缘支神经永久性麻痹的病例，但有1例放疗患者在切取皮瓣后颏下区出现裂开。结合其他外科医生报告的经验，作者的初步经验表明，颏下岛状皮瓣因其可靠性、多功能性和相对可接受的并发症，是放疗患者和未放疗患者头颈部缺损修复的一种极佳选择。
