Iwulska Katarzyna, Czajka Marcin, Jacek Drążek, Przemysław Dubis, Szuta Mariusz
Department of Maxillofacial Surgery, Rydygier Hospital, os. Złotej Jesieni 1, 31-826 Kraków, Poland.
Chair of Oral Surgery, Medical College, Jagiellonian University, Montelupich 4, 31-155 Kraków, Poland.
J Clin Med. 2025 Sep 11;14(18):6405. doi: 10.3390/jcm14186405.
: The deep circumflex iliac artery (DCIA) free flap with internal abdominal oblique muscle (IAOM) is a well-known method of reconstruction used in cases of oral cavity neoplasms. Because the IAOM can be insufficient for extensive defects after removal of advanced carcinomas of the tongue, floor of the mouth, or gingiva, the additional preparation of a perforator-supported external abdominal oblique (EAOM) muscle flap can be useful. The aim of this study was to introduce the use of a DCIA flap with an IAOM and EAOM island in the reconstruction of oral cavity compound defects. : A retrospective analysis was performed involving eight patients who underwent reconstruction using a DCIA free flap with IAOM and perforator-supported EAOM island. Patients underwent the operation between June 2021 and February 2025 in the Department of Maxillofacial Surgery of the Rydygier Hospital in Kraków, Poland. : A group of eight patients underwent an operation due to squamous cell carcinoma of the oral cavity. The most common primary subsite of disease was the floor of the mouth ( = 4, 50%), followed by the lower gingiva ( = 2, 25%) and retromolar area ( = 2, 25%). All patients required resection involving part of the mandible, the floor of the mouth, and part of the tongue simultaneously with reconstruction using a DCIA free flap with IAOM and perforator-supported EAOM island. Osteotomies were performed in two flaps (one single osteotomy, one double osteotomy). Reconstruction was successfully performed in seven out of eight patients (overall success rate 88%). : The DCIA free flap with IAOM and perforator-supported EAOM flap is a reliable method for compound soft tissue and bone defects in maxillofacial reconstruction. The use of IAOM and EAOM can be helpful in cases of three-dimensional soft tissue defects of the lower gingiva, the floor of the mouth, and the tongue. The lower gingiva and floor of the mouth can be reconstructed with IAOM, while the more mobile part of the tongue can be reconstructed with a perforator-supported EAOM island.
带腹内斜肌（IAOM）的旋髂深动脉（DCIA）游离皮瓣是口腔肿瘤病例中一种广为人知的重建方法。由于在切除晚期舌癌、口底癌或牙龈癌后，腹内斜肌对于广泛缺损可能不足，额外制备穿支血管支持的腹外斜肌（EAOM）肌皮瓣可能会有所帮助。本研究的目的是介绍带腹内斜肌和腹外斜肌岛状瓣的DCIA皮瓣在口腔复合缺损重建中的应用。：对8例使用带腹内斜肌的DCIA游离皮瓣和穿支血管支持的腹外斜肌岛状瓣进行重建的患者进行了回顾性分析。这些患者于202年6月至2025年2月在波兰克拉科夫里迪吉尔医院颌面外科接受手术。：一组8例患者因口腔鳞状细胞癌接受手术。最常见的疾病原发部位是口底（n = 4，50%），其次是下牙龈（n = 2，25%）和磨牙后区（n = 2，25%）。所有患者均需要需要同时切除部分下颌骨、口底和部分舌，同时使用带腹内斜肌的DCIA游离皮瓣和穿支血管支持的腹外斜肌岛状瓣进行重建。在两个皮瓣中进行了截骨术（一个单截骨术，一个双截骨术）。8例患者中有7例成功完成重建（总体成功率88%）。：带腹内斜肌和穿支血管支持的腹外斜肌皮瓣是颌面重建中复合软组织和骨缺损的可靠方法。在处理下牙龈、口底和舌的三维软组织缺损时，使用腹内斜肌和腹外斜肌可能会有帮助。下牙龈和口底可用腹内斜肌重建，而舌的活动度较大的部分可用穿支血管支持的腹外斜肌岛状瓣重建。
