Al-Aroomi Maged Ali, Feng Yiheng, Chen Jie, Li Ning, Jiang Canhua, Wang Jie
Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, China.
Head Neck. 2025 Jul 7. doi: 10.1002/hed.28229.
Submandibular gland flap (SMGF) has demonstrated reliability in repairing small- to medium-sized defects, yet it has not gained widespread international adoption. This study aimed to evaluate the efficacy and outcomes of SMGF for oral cancer reconstruction and compare its application with submental artery perforator flap (SMAPF).
All patients with primary oral cancer requiring reconstruction using either SMGF or SMAPF were included. Demographic and surgical outcome measures (such as harvesting time, use of lip splinting, and marginal mandibulectomy), short-term outcomes (including flap partial loss, intraoral wound dehiscence, fistula, oral bleeding, and wound infection), and long-term morbidity (including cancer recurrence, neck motion restriction, hair growth, and overall aesthetic outcomes) were assessed.
Thirty-seven patients were enrolled (SMGF, n = 16; SMAPF, n = 21). The SMGF group was older than the SMAPF group and had a shorter harvesting time (p < 0.05). Flap partial loss and neck motion restriction occurred in 3 patients in the SMAPF group. Nine patients experienced locoregional recurrence (SMGF, n = 3; SMAPF, n = 6). A significantly higher incidence of hair growth was observed in the SMAPF group (47.6%, p = 0.002). No significant difference was found in satisfaction with appearance between the two groups. There were no flap losses in the study.
SMGF reconstruction is a valuable technique, comparable to SMAPF, for repairing appropriately selected intraoral defects requiring reconstruction beyond healing by secondary intention and mobilization of adjacent tissue, but it is not large enough to necessitate free flap reconstruction.
下颌下腺瓣（SMGF）在修复中小型缺损方面已证明具有可靠性，但尚未在国际上广泛应用。本研究旨在评估SMGF用于口腔癌重建的疗效和结果，并将其应用与颏下动脉穿支皮瓣（SMAPF）进行比较。
纳入所有需要使用SMGF或SMAPF进行重建的原发性口腔癌患者。评估人口统计学和手术结果指标（如切取时间、唇部夹板使用情况和下颌骨边缘切除术）、短期结果（包括皮瓣部分坏死、口腔内伤口裂开、瘘管、口腔出血和伤口感染）以及长期并发症（包括癌症复发、颈部活动受限、毛发增生和整体美学效果）。
共纳入37例患者（SMGF组16例；SMAPF组21例）。SMGF组患者年龄大于SMAPF组，且切取时间更短（p<0.05）。SMAPF组有3例患者出现皮瓣部分坏死和颈部活动受限。9例患者出现局部复发（SMGF组3例；SMAPF组6例）。SMAPF组毛发增生发生率显著更高（47.6%，p=0.002）。两组患者对外观的满意度无显著差异。本研究中未出现皮瓣坏死情况。
对于修复需要重建且无法通过二期愈合和邻近组织动员来修复的合适口腔内缺损，SMGF重建是一种与SMAPF相当的有价值技术，但缺损面积不足以需要游离皮瓣重建。
