Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
BMC Oral Health. 2020 Mar 30;20(1):94. doi: 10.1186/s12903-020-01066-x.
Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have simultaneous oral and submandibular defects. Due to its high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by surgeons for oral reconstruction. However, the tissue volume of perforator flaps is insufficient for the reconstruction of both the oral and submandibular regions. In this retrospective cohort study, we compared the postoperative outcomes and complications between patients reconstructed with using the classical ALT perforator flap and patients reconstructed using the chimeric ALT perforator flap with vastus lateralis muscle mass.
From August 2017 to August 2019, 25 patients underwent reconstructive therapy using a classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between the two groups.
There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4 and 40% in the chimeric and classical group, respectively. The duration of recovery was 12.20 ± 2.69 and 15.67 ± 4.09 days in the chimeric and classical group, respectively. The submandibular region fullness was satisfactory in the chimeric group. The postoperative quality of life in the chimeric group was better than that in the classical group (P < 0.05).
The chimerical ALT perforator flap with muscle mass reconstructs both the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and may reduce the incidence of submandibular infection.
接受舌及颈部联合根治性切除术的舌癌患者常同时存在口腔和下颌下缺损。由于其高度的灵活性，股前外侧肌穿支皮瓣逐渐被外科医生用于口腔重建。然而，穿支皮瓣的组织量不足以同时重建口腔和下颌下区域。在这项回顾性队列研究中，我们比较了使用经典股前外侧肌穿支皮瓣重建的患者和使用股前外侧肌穿支皮瓣与股外侧肌大块重建的患者的术后结果和并发症。
2017 年 8 月至 2019 年 8 月，在中南大学湘雅医院，25 例接受舌癌根治性切除术的患者接受了经典股前外侧肌穿支皮瓣重建（经典组），而 26 例患者接受了股前外侧肌穿支皮瓣与股外侧肌大块重建（嵌合组）。比较两组患者的皮瓣存活率、下颌下感染发生率、侧貌、下肢功能和生活质量。
两组患者的皮瓣存活率和术后下肢功能无差异。嵌合组和经典组的下颌下感染发生率分别为 15.4%和 40%。嵌合组和经典组的恢复时间分别为 12.20±2.69 和 15.67±4.09 天。嵌合组下颌下区域饱满度满意。嵌合组患者术后生活质量优于经典组（P<0.05）。
带肌块的嵌合股前外侧肌穿支皮瓣能准确重建口腔和下颌下缺损。它保持了下颌下区域的轮廓和饱满度，并可能降低下颌下感染的发生率。
