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口腔癌患者应用鼻唇沟岛状皮瓣的经验

Experience of Island Nasolabial Flap for Patients with Oral Cavity Cancer.

作者信息

Hiremath Sharanabasav, Boro Sumanjit S, Dange Avadhut

机构信息

Adora hospital, VIP Road, Solapur Ho, Solapur, Maharashtra India.

Dept. of Burns and Plastic surgery, All India Institute of Medical Science, Guwahati, Assam India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):428-436. doi: 10.1007/s12070-023-04177-3. Epub 2023 Sep 7.

Abstract

AIM

To find out the utility of the island nasolabial flap in patients with oral cavity malignancy.

MATERIALS AND METHODS

This was an observational study conducted at a super-specialty hospital in Maharashtra from October 2019 to December 2021. Patients with oral malignancy planned for island nasolabial flaps were only considered.

RESULTS

A total of 20 patients were operated on, out of which 16 were males and 4 were females. All the patients were followed up for a minimum period of 6 months. The hospital's online reporting system is used for the data collection including the post-operative assessment. Out of the 20 patients, 10 patients were suffering from tongue carcinoma, 6 patients from buccal mucosal carcinoma, two from hard palate carcinoma and one patient each from the floor of the mouth and lip carcinoma. The mean age of the series was 52.3 years, the average duration of the surgery is 169.4 min and the average hospital stay in the series was 4.35 days. The Ryle's tube was removed on an average of 4.35 days. No flap-related complications were noted during the series, and healing of the donor site was uneventful. The functional outcomes after the reconstruction are acceptable in all the cases except in the lip reconstruction patient where there was post-operative drooling.

CONCLUSION

The island nasolabial flap is relatively easy to harvest and less time-consuming. The other advantages include the post-operative surgical scar falls along the nasolabial fold, long pedicle length with preservation of the facial pedicle for future microvascular use, early transfer to the oral feed from the nasogastric feed, and early de-cannulation. In our small study, we observed that the island nasolabial flap is a very useful flap for the small to moderate-sized defects of the oral cavity. We feel, one of the disadvantages of this flap is that it is not an ideal flap for lip reconstruction.

摘要

目的

探讨岛状鼻唇沟皮瓣在口腔恶性肿瘤患者中的应用价值。

材料与方法

这是一项于2019年10月至2021年12月在马哈拉施特拉邦一家超级专科医院开展的观察性研究。仅纳入计划采用岛状鼻唇沟皮瓣治疗的口腔恶性肿瘤患者。

结果

共对20例患者进行了手术,其中男性16例,女性4例。所有患者均接受了至少6个月的随访。通过医院的在线报告系统收集包括术后评估在内的数据。20例患者中,10例患有舌癌,6例患有颊黏膜癌,2例患有硬腭癌,1例患有口底癌,1例患有唇癌。该组患者的平均年龄为52.3岁,平均手术时长为169.4分钟,平均住院时间为4.35天。鼻饲管平均在4.35天后拔除。该组病例中未发现与皮瓣相关的并发症,供区愈合顺利。除唇重建患者术后出现流涎外,所有病例重建后的功能结局均可接受。

结论

岛状鼻唇沟皮瓣相对易于切取且耗时较短。其他优点包括术后手术瘢痕位于鼻唇沟,蒂长且保留面部蒂以便未来微血管使用,能从鼻饲早期转为经口进食,且能早期拔管。在我们的小型研究中,我们观察到岛状鼻唇沟皮瓣对于口腔中小面积缺损是一种非常有用的皮瓣。我们认为,该皮瓣的一个缺点是它并非唇重建的理想皮瓣。

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本文引用的文献

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Island Nasolabial Flap for Tongue Reconstruction: Locoregional Flap of Choice and an Alternative to Free Flap for Tongue Cancer.
Indian J Surg Oncol. 2021 Mar;12(1):94-99. doi: 10.1007/s13193-020-01214-3. Epub 2020 Sep 17.
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