颏下岛状瓣在口腔颌面部恶性肿瘤切除术后修复中的应用

doi:10.3969/j.issn.1005-4979.2021.04.04

摘要/Abstract

摘要：

目的： 探讨颏下岛状瓣（submental artery island flap, SIF）在修复口腔及颌面部恶性肿瘤术后缺损中的临床应用价值。方法： 回顾性地分析了2017年6月—2020年6月，我科颌面部恶性肿瘤手术切除后同期行颏下岛状瓣修复的患者资料，并以同期行血管化游离股前外侧肌皮瓣修复的患者作为对照组，两组共30例。使用SPSS 19.0软件包进行统计分析。结果： 使用颏下岛状瓣修复口腔颌面部恶性肿瘤术后缺损共11例，皮瓣均完全成活，皮瓣大小在3 cm×4 cm~4 cm×10 cm。无论是T2期肿瘤还是T3期肿瘤切除后的缺损，颏下岛状瓣的手术时间和术后恢复时间均明显小于血管化游离股前外侧肌皮瓣（P<0.05）。结论： 颏下岛状瓣小巧灵活，制作简便，无须血管吻合及开辟远位供区，可以缩短手术时间及术后恢复时间，且术后瘢痕隐蔽。适用于修复恶性肿瘤切除术后面中下2/3的中小型缺损，但要选择合适的手术适应证。

关键词: 颏下岛状瓣, 游离股前外侧肌皮瓣, 恶性肿瘤, 口腔颌面部缺损

Abstract:

Objective: To evaluate the application effects of the submental artery island flap(SIF) in repairing orofacial defects after malignant tumor resection. Methods: Clinical procedures were carried out between June 2017 and June 2020. A total of 30 patients who underwent tumor resection and immediate defect reconstruction with submental artery island flaps were recruited. In comparison with anterolateral thigh flap(ALTF) as control. Statistical analysis was performed using SPSS 19.0 software to compare the differences between the two groups. Results: All 11 cases of SIFs were ultimately successful. The flap sizes were 3 cm × 4 cm-4 cm × 10 cm. For repairing the defects of either T2 tumors or T3 tumors followed by extended resection. Time spent in SIF reconstruction was significantly shorter and less postoperative recovery time than that of ALTF group(P<0.05). Conclusion: The SIF is flexible and easy to be raised without distal donor site incision and microvascular procedure. It is suitable for repairing the small- or medium-sized defect of the lower two-thirds of the face after malignant tumor resection, but the indications should be appropriately selected.

Key words: submental artery island flap, free anterolateral thigh flap, malignant tumors, maxillofacial defects

石海波, 项丹威, 叶佳朋, 吴春月, 宋丽娜, 刘麒麟. 颏下岛状瓣在口腔颌面部恶性肿瘤切除术后修复中的应用[J]. 《口腔颌面外科杂志》, 2021, 31(4): 221-225.

SHI Haibo, XIANG Danwei, YE Jiapeng, WU Chunyue, SONG lina, LIU Qilin. Clinical application of submental island flap to repair orofacial defects after malignant tumor resection[J]. 《Journal of Oral and Maxillofacial Surgery》, 2021, 31(4): 221-225.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2021/V31/I4/221

图/表 3

参考文献 17

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一般特征	SIF组	ALTF组	P值
例数	11	19	-
平均年龄（岁）	63.4（52~77）	58.8（39~73）	0.3248
性别
男	7（66.6%）	13（68.4%）	0.7888
女	4（33.4%）	6（31.6%）
伴发系统疾病（高血压、心脏病、脑梗等）	9（81.8%）	10（52.6%）	0.0485
肿瘤分期		-
T1	2（18.2%）	0（0）
T2	7（63.6%）	6（31.5%）
T3	2（18.2%）	11（57.8%）
T4	0（0）	2（12.5%）
缺损部位			-
眶下区	1（9.1%）	0（0）
腮腺区	1（9.1%）	0（0）
颊黏膜	2（18.2%）	3（15.8%）
舌体	5（45.5%）	9（47.4%）
下颌牙龈	1（9.1%）	1（5.3%）
口底	1（9.1%）	6（31.6%）

一般特征	SIF组	ALTF组	P值
例数	11	19	-
平均年龄（岁）	63.4（52~77）	58.8（39~73）	0.3248
性别
男	7（66.6%）	13（68.4%）	0.7888
女	4（33.4%）	6（31.6%）
伴发系统疾病（高血压、心脏病、脑梗等）	9（81.8%）	10（52.6%）	0.0485
肿瘤分期		-
T1	2（18.2%）	0（0）
T2	7（63.6%）	6（31.5%）
T3	2（18.2%）	11（57.8%）
T4	0（0）	2（12.5%）
缺损部位			-
眶下区	1（9.1%）	0（0）
腮腺区	1（9.1%）	0（0）
颊黏膜	2（18.2%）	3（15.8%）
舌体	5（45.5%）	9（47.4%）
下颌牙龈	1（9.1%）	1（5.3%）
口底	1（9.1%）	6（31.6%）

	手术时间/h			术后恢复时间/d
组别	T2期	T3期		T2期	T3期
SIF组	3.74±0.53^*	4.38±0.81^*	11.33±1.15^*		13.33±2.08^*
ALTF组	8.70±0.97	9.08±0.73	15.66±3.39		20.16±5.25

	手术时间/h			术后恢复时间/d
组别	T2期	T3期		T2期	T3期
SIF组	3.74±0.53^*	4.38±0.81^*	11.33±1.15^*		13.33±2.08^*
ALTF组	8.70±0.97	9.08±0.73	15.66±3.39		20.16±5.25

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