Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Rd, Guangzhou 510120, China; The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China; Craniomaxillofacial Surgery Center, Sun Yat-sen University, Guangzhou City, China.
Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Rd, Guangzhou 510120, China; The Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China.
J Plast Reconstr Aesthet Surg. 2022 Oct;75(10):3877-3903. doi: 10.1016/j.bjps.2022.08.074. Epub 2022 Aug 26.
Lip-splitting approach for oncologic resection and defect reconstruction of tongue squamous cell carcinoma (TSCC) needs modification to avoid unfavorable esthetic results. Forty-three patients with TSCC underwent surgery using the modified submandibular mandibulotomy(MSMM) approach without lip-splitting and another matched 43 patients using lip-splitting mandibulotomy (LSM) approach were reviewed retrospectively. Clinical outcomes evaluation consisted of tumor exposure, resection margin, surgical morbidity, locoregional recurrence, survival status, scar scores and quality of life (QOL). All the tumors were en bolc removed by MSMM approach and LSM approach through combined intraoral routes with excellent tumor exposure and R0 resection margins. Tumor recurrence rates and swallowing, chewing, speech were similar in both groups. The MSMM approach was associated with significantly better facial appearance and recreation than LSM approach. The MSMM approach without lip-splitting is safe and effective, achieves better QOL compared to LSM approach in patients with TSCC.
唇裂入路在口腔鳞癌（TSCC）的肿瘤切除和缺损重建中需要进行改良，以避免不良的美容效果。43 例 TSCC 患者采用改良下颌下颌骨切开术（MSMM）入路，无唇裂，另 43 例匹配的患者采用唇裂下颌骨切开术（LSM）入路。回顾性分析两组患者的临床结果，包括肿瘤暴露、切除边缘、手术并发症、局部区域复发、生存状况、瘢痕评分和生活质量（QOL）。所有肿瘤均通过 MSMM 入路和 LSM 入路通过联合口腔内途径整块切除，肿瘤暴露和 R0 切除边缘均良好。两组肿瘤复发率和吞咽、咀嚼、言语功能相似。MSMM 入路与 LSM 入路相比，面部外观和再造效果明显更好。MSMM 入路不切开唇裂，在 TSCC 患者中与 LSM 入路相比，具有更好的生活质量。
