用于肿瘤切除术后获得性上颌和腭部缺损重建的颏下动脉岛状皮瓣：逆流与延长顺行设计
The Submental Artery Island Flap for Reconstruction of Acquired Maxillary and Palatal Defects After Tumor Ablation: Reversed Flow Versus the Extended Antegrade Design.
作者信息
Amin Ayman A, Jamali Omer M, Farid Ramez, Zedan Mohamed H, Ghobrial Romany Esshak, Zakka Reem, Rifaat Mohammed A
机构信息
Department of Surgical Oncology, Division of Head and Neck Surgery, National Cancer Institute, Cairo University, Cairo, Egypt.
Department of Surgical Oncology, Shefa Al-Orman Cancer Hospital, Luxor, Egypt.
出版信息
Head Neck. 2025 May;47(5):1355-1363. doi: 10.1002/hed.28043. Epub 2024 Dec 23.
BACKGROUND
The submental artery island flap (SIF) is a valid option for palatal reconstruction. However, the main limitation for its application for palatal defects is the arc of rotation. A novel modification for tunneling of the antegrade design of SIF that allows a compliant easy reach to the defect is described.
METHODS
Eighteen patients with Brown class II maxillectomy defects were included. Reconstruction started using reversed flow SIF in five patients then shifted to the modified antegrade technique in the remaining patients. Speech, swallowing, chewing, other parameters, and oncological outcomes were assessed.
RESULTS
The reversed flow group has high complications. In the antegrade SIF group, all flaps survived. One developed marginal flap necrosis that healed spontaneously. The follow-up period ranged from 1 to 4.2 years with favorable functional outcome and with no evidence of recurrence.
CONCLUSION
The modified SIF antegrade design is a reliable option for palate reconstruction that allows favorable functional and oncological outcome.
背景
颏下动脉岛状皮瓣（SIF）是腭部重建的一种有效选择。然而，其应用于腭部缺损的主要限制是旋转弧度。本文描述了一种对SIF顺行设计隧道的新颖改良方法，该方法可使皮瓣顺利轻松地到达缺损部位。
方法
纳入18例Brown II类上颌骨切除术后缺损患者。5例患者开始采用反流SIF进行重建，其余患者则改用改良顺行技术。对语音、吞咽、咀嚼、其他参数及肿瘤学结局进行评估。
结果
反流组并发症发生率高。在顺行SIF组中，所有皮瓣均存活。1例出现皮瓣边缘坏死，但自行愈合。随访时间为1至4.2年，功能结局良好，且无复发迹象。
结论
改良SIF顺行设计是腭部重建的可靠选择，可带来良好的功能和肿瘤学结局。
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