基于对侧的颏下岛状皮瓣用于舌及口底缺损的重建：可靠性及肿瘤学结局
The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: Reliability and oncological outcome.
作者信息
Amin Ayman A, Jamali Omer M, Ibrahim Ahmed S, Rifaat Mohamed A, Zedan Mohamed H
机构信息
Department of Surgical Oncology, Division of Head and Neck Surgery, National Cancer Institute, Cairo University, Cairo, Egypt.
Department of Surgical Oncology, Shefa Al-Orman Cancer Hospital, Luxor, Egypt.
出版信息
Head Neck. 2020 Oct;42(10):2920-2930. doi: 10.1002/hed.26338. Epub 2020 Aug 5.
BACKGROUND
Submental artery island flap (SIF) is a viable alternative to free flaps for selected oral-cavity defects, however, concerns about its oncologic safety still exists. A novel harvesting technique and its outcome is described in here.
METHODS
This is a prospective study for patients with lateralized oral tongue and/or floor of mouth (FOM) cancers who undergone reconstruction using pedicled SIF based on contralateral submental vessels (CSIF) following resection.
RESULTS
Forty-one patients were included. Twenty-four patients had T2, 13 had T3, and 4 had T1 tumors. The largest flap skin paddle was 15 × 9 cm. One patient sustained complete and five sustained partial flap loss. Three patients developed tongue tethering. Median follow-up was 13.6 months. Locoregional recurrence occurred in 11 patients (26.8%); 6 oral-cavity recurrences (14.6%), 6 ipsilateral, and 1 contralateral neck recurrences (2.4%).
CONCLUSION
CSIF is a reliable flap that addresses the oncologic controversy and overcomes the disadvantages of ipsilateral flap.
背景
对于特定的口腔缺损，颏下动脉岛状皮瓣（SIF）是游离皮瓣的一种可行替代方案，然而，对其肿瘤学安全性的担忧仍然存在。本文描述了一种新的切取技术及其效果。
方法
这是一项针对接受基于对侧颏下血管（CSIF）的带蒂SIF重建术的偏侧性口腔舌癌和/或口底（FOM）癌患者的前瞻性研究。
结果
纳入41例患者。24例患者为T2期，13例为T3期，4例为T1期肿瘤。最大的皮瓣皮岛为15×9cm。1例患者皮瓣完全坏死，5例部分坏死。3例患者出现舌系带挛缩。中位随访时间为13.6个月。11例患者（26.8%）出现局部区域复发；6例口腔复发（14.6%），6例同侧复发，1例对侧颈部复发（2.4%）。
结论
CSIF是一种可靠的皮瓣，解决了肿瘤学争议，克服了同侧皮瓣的缺点。
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