颏下岛状瓣修复面部组织缺损

Reconstruction of facial defect with submental island flap

目的探讨颏下岛状瓣修复面部组织缺损的应用效果。方法6例面部病变患者,其中男4例,女2例;最小年龄44岁,最大78岁。病变部位:左面部2例,左腮腺区1例,右腮腺区1例,右面部2例。病变性质:皮样囊肿感染伴皮肤坏死1例,皮脂腺囊肿感染伴皮肤坏死1例,皮肤上皮瘤恶变1例,鳞状细胞癌3例。良性病变切除后,恶性病变扩大切除同期行颈淋巴清扫术后,面部缺损均以颏下岛状瓣即时修复。组织缺损范围最小4.0cm×3.0cm,最大6.0cm×6.0cm。组织瓣最小面积4.5cm×3.0cm,最大6.0cm×4.5cm。组织瓣以颏下动脉为蒂3例,颏下动脉联合面动脉为蒂3例。蒂的长度:6cm3例,9cm2例,11cm1例。结果6例组织瓣均存活良好,肤色与面部无明显差异;未发生任何并发症。供区伤口Ⅰ期愈合,平视位时,供区瘢痕不显露。结论颏下岛状瓣修复面部组织缺损是一种可供选择的良好方法。

Objective To explore the effect of the submental island flap in reconstruction of facial defects. Methods Six patients （4 men and 2 women） with lesions in maxillofacial regions were registried in our clinical database. Patients age ranged from 44 to 78 years, lesions were distributed in left face （2 cases）, left parotid area （1 case）, right parotid area （1 case）, and right face （2 cases）. The pathologic diagnoses were dermoid cyst with local skin necrosis （1 case ）, sebaceous cyst with inflammation and necrosis （1 case）, canceration of epithelial tumor （1 case） and squamous cell carcinoma （3 cases）. The benign tumors were resected and malignant tumors were extensively resected with neck dissection. The defects （minimum 4.0 cm× 3.0 cm.0 maximum 6.0 cm× 6.0 cm ） after surgical resection were reconstructed with the submental island flap. The flap area ranged from 4.5 cm× 3.0 cm to 6.0 cm × 4.5 cm. The flap pedicle included submental artery （3 cases） and both submental artey and facial artery （ 3 cases ）. The length from end of flaps to origin of pedicle was 6 cm in 3 cases,9 cm in 2 cases and 11 cm in 1 case. Results The flaps survived in all six cases, no obvious difference in colour was found between the flaps and facial skin; no infection at recipient site, unhealed and necrosis occurred. The wounds of donor sites were primarily healed, and the scar of donor site was out of sight when looked with eyesight parallel to the ground. Conclusion It is an ideal method to reconstruct facial defects with submental island flap.