Wang Dong, Liu Chang, Liu Liang, Zhang Kai
Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233004, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 May 15;37(5):601-604. doi: 10.7507/1002-1892.202301011.
To explore the effectiveness of folded transverse superficial epigastric artery perforator flap in repairing the large penetrating defect after buccal carcinoma resection.
Between January 2019 and June 2021, 12 patients with buccal squamous cell carcinoma were treated. There were 6 males and 6 females with an average of 66.9 years (range, 53-79 years). The pathological stage was T3a-T4b, and the preoperative mouth opening was (3.08±0.46) cm. The disease duration ranged from 6 to 24 months, with an average of 15 months. After buccal carcinoma radical resection and neck lymph node dissection, the penetrating defects in size of 8 cm×6 cm to 16 cm×8 cm and in depth of 0.5-1.5 cm were remained. The transverse superficial epigastric artery perforator flap in size of 8 cm×6 cm to 14 cm×8 cm were harvested and folded to repair the penetrating defects. The donor site was sutured directly.
All 12 skin flaps survived after operation, and the wounds healed by first intention. No internal or external fistula complications occurred. All incisions at the recipient site healed by first intention. All patients were followed up 12-18 months (mean, 14 months). There was no obvious abnormality in the color and texture of the flap, the oral and facial appearances were symmetrical, and there was no obvious swelling in the cheek. At last follow-up, the patient's mouth opening was (2.89±0.33) cm, which was not significantly different from that before operation ( =1.879, =0.087). The subjective satisfaction scores of 12 patients were 6-8 points, with an average of 7.3 points. Significant scars remained at the donor site but concealed in location.
The folded transverse superficial epigastric artery perforator flap can be used as a surgical method for repairing large penetrating defects after the buccal carcinoma resection, with a good recovery of facial appearance and oral function.
探讨折叠式腹壁浅动脉穿支皮瓣修复颊癌切除术后大型贯通性缺损的疗效。
2019年1月至2021年6月，收治12例颊部鳞状细胞癌患者。男6例，女6例，平均年龄66.9岁（范围53 - 79岁）。病理分期为T3a - T4b，术前开口度为(3.08±0.46)cm。病程6至24个月，平均15个月。颊癌根治性切除及颈部淋巴结清扫术后，遗留大小为8 cm×6 cm至16 cm×8 cm、深度为0.5 - 1.5 cm的贯通性缺损。切取大小为8 cm×6 cm至14 cm×8 cm的腹壁浅动脉穿支皮瓣并折叠修复贯通性缺损。供区直接缝合。
术后12块皮瓣全部成活，伤口一期愈合。未发生内外瘘等并发症。受区所有切口均一期愈合。所有患者随访12 - 18个月（平均14个月）。皮瓣颜色、质地无明显异常，口腔及面部外形对称，颊部无明显肿胀。末次随访时，患者开口度为(2.89±0.33)cm，与术前相比差异无统计学意义（t = 1.879，P = 0.087）。12例患者主观满意度评分为6 - 8分，平均7.3分。供区遗留明显瘢痕，但位置隐蔽。
折叠式腹壁浅动脉穿支皮瓣可作为颊癌切除术后修复大型贯通性缺损的手术方法，面部外形及口腔功能恢复良好。
