Akheel Mohammad, Wadhwania Ashmi
College of Dentistry, City University Ajman, Ajman, UAE.
Adjunct Faculty, Dept. of Oral & Maxillofacial Surgery, Saveetha Institute of Medical & Technical Sciences, Chennai, India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3312-3319. doi: 10.1007/s12070-023-03959-z. Epub 2023 Jun 20.
Submental flap is a gaining popularity as a reconstruction of orofacial defects in post-ablative defects, especially in situations where free flap services are not available or feasible. The background of this study was to demonstrate the oncological safety and benefits of this flap in oral cavity reconstruction. A retrospective analysis of 50 patients from the age group 28 to 70 years with oral cavity cancers of different subsites, who underwent submental flap reconstruction from 2018 to 2022 at our hospital for various ablative defects of oral cavity, were included in the study. We have reviewed the parameters like flap complications, post-operative mouth opening after 1 year and nodal recurrence. There were 37 males and 13 females patients in the study. 29(58%) patients had buccal cancers, 11(22%) patients had tongue cancer, 7(14%) patients had retromolar trigone cancer and 3(6%) had gingivo-buccal cancers. All patients underwent resection with ipsilateral selective neck dissection after flap was harvested. Complete flap loss was observed in 1(2%) patient, whereas as the flap dehiscence was seen in 3(6%) patients. Mean follow-up was 12 months. There were 3(6%) cases of nodal recurrence on the same side of flap after a mean time of 5 months of surgery. Inter-Incisal mouth opening was 20-30 mm in 68% of the cases. On the 1 year follow-up, all the patients were alive with no mortality. Oncologic outcome in terms of overall survival was found to be 94% in patients reconstructed with submental flap which makes it versatile for oral cavity reconstructions. Submental flap is a robust flap for oral cavity reconstruction. However, preoperative selection of clinically neck node-negative patient is extremely important as it has potential risk of occult metastasis and oncologic safety.
颏下皮瓣作为一种用于修复口腔癌切除术后缺损的方法，越来越受到欢迎，特别是在无法获得或无法实施游离皮瓣手术的情况下。本研究的目的是证明该皮瓣在口腔重建中的肿瘤学安全性和益处。本研究纳入了50例年龄在28至70岁之间、患有不同部位口腔癌的患者，他们于2018年至2022年在我院接受了颏下皮瓣重建手术，以修复各种口腔切除术后缺损。我们回顾了皮瓣并发症、术后1年的张口度和淋巴结复发等参数。研究中有37例男性患者和13例女性患者。29例（58%）患者患有颊癌，11例（22%）患者患有舌癌，7例（14%）患者患有磨牙后三角癌，3例（6%）患有牙龈颊癌。所有患者在切取皮瓣后均接受了同侧选择性颈清扫术。1例（2%）患者出现皮瓣完全坏死，3例（6%）患者出现皮瓣裂开。平均随访时间为12个月。平均术后5个月，有3例（6%）患者在皮瓣同侧出现淋巴结复发。68%的病例切牙间张口度为20 - 30毫米。在1年的随访中，所有患者均存活，无死亡病例。采用颏下皮瓣重建的患者总体生存率为94%，这表明该皮瓣在口腔重建中具有通用性。颏下皮瓣是一种用于口腔重建的可靠皮瓣。然而，术前选择临床颈部淋巴结阴性的患者极为重要，因为其存在潜在的隐匿性转移风险和肿瘤学安全性问题。
