Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, China.
Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, China; Institute of Oral Precancerous Lesions, Central South University, No. 87, Xiangya Road, Changsha, China; Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University，No. 87, Xiangya Road, Changsha, China.
Br J Oral Maxillofac Surg. 2021 Oct;59(8):881-887. doi: 10.1016/j.bjoms.2020.08.120. Epub 2020 Oct 12.
The submental artery perforator flap (SAPF) has been a new option for the intraoral reconstruction of oral squamous cell carcinoma (OSCC) patients in recent years, but its surgical outcomes have not been well assessed. We compared the surgical outcomes and oncological safety of SAPF reconstruction for medium-sized soft-tissue defects after the ablation of primary oral cancer with traditional submental island flaps (SIF) and anterolateral thigh perforator flaps (ALTPF). Fifty-one SAPFs, 30 SIF, and 74 ALTPF were reviewed for the intraoral medium-sized reconstructions after the ablation of oral cancer from our institutional clinical oncological databases. We performed comparative assessments on the variables of surgical outcome and oncological safety among the 3 cohorts. A Kaplan-Meier estimate of survival for each flap was calculated. Operating time was significantly reduced in the SIF and SAPF groups than ALTPF (p = 0.021 and 0.014, respectively). Flap thickness of SAPF was the significantly thinnest (mean 0.5 cm) among three groups. The common complications of donor site for both SAPF and SIF group were incision dehiscence and orocutaneous fistula. There was no significant difference in disease-free survival (DFS) among the 3 groups. However, several OSCC patients with the SIF reconstruction were found to have recurrences with a metastatic lymph node under the flap after the first operation. SAPF could be a versatile choice of the intraoral reconstruction for the medium-sized soft-tissue defects after the ablation of oral cancer.
颏下动脉穿支皮瓣（SAPF）近年来已成为口腔鳞状细胞癌（OSCC）患者口腔内重建的新选择，但对其手术效果尚未进行充分评估。我们比较了 SAPF 与传统颏下岛状皮瓣（SIF）和股前外侧穿支皮瓣（ALTPF）用于原发性口腔癌消融后中等大小软组织缺损的口腔内重建的手术效果和肿瘤安全性。我们从机构临床肿瘤学数据库中回顾了 51 例 SAPF、30 例 SIF 和 74 例 ALTPF 用于口腔癌消融后的口腔内中等大小重建。我们对 3 组间手术结果和肿瘤安全性的变量进行了比较评估。对每个皮瓣的生存进行了 Kaplan-Meier 估计。与 ALTPF 相比，SIF 和 SAPF 组的手术时间明显缩短（分别为 p = 0.021 和 0.014）。SAPF 的皮瓣厚度是三组中最薄的（平均 0.5cm）。SAPF 和 SIF 组供区的常见并发症为切口裂开和口皮瘘。3 组间无病生存率（DFS）无显著差异。然而，一些接受 SIF 重建的 OSCC 患者在首次手术后发现皮瓣下有复发和转移性淋巴结。SAPF 可为口腔癌消融后中等大小软组织缺损的口腔内重建提供一种多功能的选择。
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