Pradhan Pradeep, Preetam Chappity, Sarkar Sourav, Samal Dillip Kumar, Parida Pradipta Kumar
Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019 India.
J Maxillofac Oral Surg. 2022 Jun;21(2):312-319. doi: 10.1007/s12663-020-01464-2. Epub 2020 Oct 15.
To assess the utility of the combined use of pectoralis major myocutaneous (PMMC) flap and deltopectoral flap (DP) in advanced oral cavity cancers in the Indian population.
It is a retrospective study, considering 29 patients with stage IV carcinoma of the oral cavity, from July 2015 to February 2019. Both pectoralis major Myocutaneous flaps and deltopectoral flaps were used for stage IV oral cancers involving the full-thickness cheek and the mandibular cortex. The reliability of the flaps and clinical outcomes were evaluated in the postoperative period.
Of the 29 patients, partial necrosis of the skin island was detected in 6 patients, 2 patients presented with wound dehiscence, and one patient had an orocutaneous fistula. Recurrence was detected in 3(10.34%) patients, in one patient, it was at the primary site and in 2 patients, it was in the neck. When different parameters were compared between the patients with complications and without complications, the comorbidities like smoking and alcohol intake adversely affected the flap survival in the postoperative period.
The combined use of PMMC and DP flap can be a reliable option for advanced oral malignancies, especially in patients with poor performance status with the coexisting chronic illness. Due to the presence of a definite vascular pedicle, ease of harvesting the flap, quick surgical procedure, and the minimal postoperative morbidities, these pedicle flaps can be successfully used alternative to the free flaps in advanced oral cancers, especially patients with a low socioeconomic corridor like India.
评估胸大肌肌皮瓣（PMMC）和三角肌胸大肌皮瓣（DP）联合应用于印度人群晚期口腔癌的效用。
这是一项回顾性研究，纳入了2015年7月至2019年2月期间的29例IV期口腔癌患者。胸大肌肌皮瓣和三角肌胸大肌皮瓣均用于涉及全层颊部和下颌骨皮质的IV期口腔癌。术后评估皮瓣的可靠性和临床结局。
29例患者中，6例出现皮岛部分坏死，2例出现伤口裂开，1例出现口腔皮肤瘘。3例（10.34%）患者出现复发，1例在原发部位复发，2例在颈部复发。比较有并发症和无并发症患者的不同参数时，吸烟和饮酒等合并症对术后皮瓣存活有不利影响。
PMMC和DP皮瓣联合应用对于晚期口腔恶性肿瘤可能是一种可靠的选择，尤其是对于伴有慢性疾病、身体状况较差的患者。由于存在明确的血管蒂、皮瓣切取容易、手术过程快速且术后发病率低，这些带蒂皮瓣可成功替代游离皮瓣用于晚期口腔癌，尤其是像印度这样社会经济水平较低地区的患者。
