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基于隧道化面动脉肌黏膜岛皮瓣和下颌下腺瓣的新型局部嵌合皮瓣用于口腔鳞状细胞癌手术后的重建。

Novel Local Chimeric Flap Based on Tunnelized Facial Artery Myomucosal Island Flap and Submandibular Gland Flap for Reconstructions After Oral Squamous Cell Carcinoma Surgery.

机构信息

Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University.

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University.

出版信息

J Craniofac Surg. 2023;34(1):76-82. doi: 10.1097/SCS.0000000000008862. Epub 2022 Aug 9.

Abstract

The reconstruction of oral tongue and floor of mouth defects after resections of squamous cell carcinoma is a challenging task in reconstructive surgery aiming for appropriate restoration of oral function and quality of life improvement. In this study, the authors introduce the innovative reconstruction technique of medium-sized defects consisting of tunnelized facial artery myomucosal island flap and submandibular gland flap as the local chimeric flap pedicled on facial vessels. A retrospective case series evaluation of 4 patients suffering from oral cavity cancer (stages III and IVa), who underwent transoral tumor excision with neck dissection and immediate reconstruction in the time period September 2020 to July 2021, was conducted. No flap losses or flap-related complications were identified. No recurrences occurred during the follow-up at 11.0±4.5 months (range: 6-16 mo, median=11 mo). Tunnelized facial artery myomucosal island flap and submandibular gland flap local chimeric flap expands the reconstruction options of medium-sized defects after ablative oral cancer surgery in carefully selected patients primarily not suitable for free flap reconstructions.

摘要

口腔舌及口底鳞状细胞癌切除后缺损的重建是重建外科的一项挑战,旨在适当恢复口腔功能和提高生活质量。在这项研究中,作者介绍了一种由隧道化面动脉肌黏膜岛瓣和下颌下腺瓣组成的中型缺损重建的创新技术,该技术是基于面血管的局部嵌合皮瓣。对 2020 年 9 月至 2021 年 7 月期间接受经口肿瘤切除术和颈部清扫术及即刻重建的 4 例口腔癌(III 期和 IVa 期)患者进行了回顾性病例系列评估。未发现皮瓣丢失或与皮瓣相关的并发症。在 11.0±4.5 个月(范围:6-16 mo,中位数=11 mo)的随访中无复发。隧道化面动脉肌黏膜岛瓣和下颌下腺瓣局部嵌合皮瓣为经口切除口腔癌术后中等大小缺损的重建提供了更多选择,主要适用于不适合游离皮瓣重建的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1602/9794126/b439814b8aef/scs-34-076-g001.jpg

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