颏下蒂岛状皮瓣在口腔癌术后口内缺损修复中的应用

The submental island flap for reconstruction of intraoral defects in oral cancer patients

目的：探讨颏下蒂岛状皮瓣在口腔癌术后口内缺损一期修复中的应用效果。方法：对我科2010年9月～2014年6月应用颏下蒂岛状皮瓣修复24例口腔癌术后口内软组织缺损患者的临床资料进行回顾性分析，观察皮瓣的存活情况及近、远期临床效果。结果：1例下牙龈癌患者术后皮瓣出现静脉危象坏死，予以清除，创面拉拢缝合。23例皮瓣全部存活。术后随访6～36个月，该组病例均未见肿瘤复发与转移。组织瓣血运丰富，皮瓣形态良好，无臃肿，外观和功能满意。结论：颏下岛状皮瓣具有血管蒂恒定、制备简单、可旋转幅度大，厚度适中、易于成活及供区隐蔽等优点，是口腔癌切除后软组织缺损修复的较理想选择。

Objective The aims of the study is to assess the usefulness of submental island flap in oral reconstruction. Methods From September 2010 to June 2014,Total 24 patients who underwent ablative surgery suffered from oral cancer and reconstruction using the submental artery island flap in one stage.The short and long term effects were observed.There were 15 men and 9 women, ages of whom ranged from 47 years to 81 years with a mean 63.8 years. The size of the skin paddle ranged from 5cm＆#237;4cm to 10cm＆#237;6cm. Results 23 cases flaps survived in this study. One case with carcinoma of inferior gingival was failed because of flap necrosis caused by venous embolism. Donor site healing was excellent in all cases and the donor site scar was well hidden.The long term cosmesis and functions were good in all the patients.Followed up 6~36 months,tumor recurrence and metastasis were not observed in this group. Conclusion The submental artery island flap is a simple and reliable option for oral cancer reconstruction due to its reliable vascular pedicle,fitting thickness, high successful ratio in carefully selected cases,with acceptable cosmetic and functional results and reasonable oncological safety.