颏下岛状肌皮瓣修复口腔鳞癌术后颊黏膜缺损效果观察

Clinical observation of submental myocutaneous island flap for reconstructing defects of buccal mucosa after OSCC ablationST

目的 评价颏下岛状肌皮瓣修复口腔鳞癌术后颊黏膜缺损的疗效.方法 对9例口腔癌患者行口腔鳞癌扩大切除术,对颊黏膜缺损采用颏下岛状肌皮瓣修复.制备岛状肌皮瓣最小为4 cm × 6 cm,最大为5cm×10cm.结果 9例皮瓣均完全成活,1例术后发生暂时性面神经下颌缘支麻痹,3个月后恢复,2例发生颌下区积液,经拆除切口缝线2针、引流后痊愈.随访时间6 ～ 12个月,9例颊部两侧基本对称,吞咽及咀嚼功能恢复满意,开口度达2.5指2例,达3指7例.供区瘢痕隐蔽,仰头无明显受限,未发现肿瘤局部及颈部复发.结论 采用颏下岛状肌皮瓣修复口腔鳞癌术后黏膜缺损具有血供可靠、邻近受区、制备方便、皮瓣成活率高的特点,效果较好.

Objective To evaluate the curative effect of submental myocutaneous island flap for repairing the defects of buccal mucosa after oral squamous cell carcinoma （OSCC） ablation.Methods A total of 9 cases with bucccal mucosa defects following OSCC ablation were reconstructed with submental myocutaneous island flaps.The sizes of skin paddle varied from a minimum of 4 cm × 6 cm to a maximum of 5 cm × 10cm.Results The submental myocutaneous island flaps of all patients survived well.There was one case who had temporary palsy of marginal mandibular branch of the facial nerve,but recovered after 3 months.Two cases had hydrops in the mandibular region,but healed well through draining for 3-5 days.The followed-up time was 6-12 months （8 months on average）.The appearance of the cheek in patients was on the whole symmetry in left and right,and chewing functions as well as swallowing functions were re-obtained satisfactorily.Two cases had a 2.5-finger mouth opening,7 cases had a 3-finger mouth opening.The donor site left a well-hidden scar,and all patients had no head rotation dysfunctions,and no case showed recurrence or metastasis in buccal area and neck region.Conclusion Reconstructing the defects of buccal mucosa after OSCC ablation with submental myocutaneous island flaps has reliable blood supply,which is near to recipient site and convenient to be prepared,and with high successful rate of flaps.