颏下动脉穿支皮瓣修复泪囊癌眼眶缺损1例报告及文献复习

doi:10.12439/kqhm.1005-4979.2025.01.014

《口腔颌面外科杂志》 ›› 2025, Vol. 35 ›› Issue (1): 75-78. doi: 10.12439/kqhm.1005-4979.2025.01.014

颏下动脉穿支皮瓣修复泪囊癌眼眶缺损1例报告及文献复习

于寒冰¹(), 姜菲菲¹, 曹弘薇¹, 阎艾慧¹, 谭学新², 赵宁¹()

¹ 中国医科大学附属第一医院耳鼻咽喉头颈外科，沈阳　 110001
² 中国医科大学附属口腔医院口腔颌面外科，沈阳　 110001

收稿日期:2024-10-29 接受日期:2025-01-03 出版日期:2025-02-28 上线日期:2025-02-28
通讯作者: 赵宁
作者简介:
于寒冰，主治医师．E-mail:yyyhhhbbb888@163.com
基金资助:
辽宁省教育厅基本科研项目(LJKMZ20221140)

Submental artery perforator flap for repair of orbital defect of lacrimal sac carcinoma: A case report and literature review

YU Hanbing¹(), JIANG Feifei¹, CAO Hongwei¹, YAN Aihui¹, TAN Xuexin², ZHAO Ning¹()

¹ Department of Otorhinolaryngology-Head and Neck Surgery, the First Hospitai of China Medical University, Shenyang 110001
² Department of Oral and Maxillofacial Surgery, Stomatological Hospital of China Medical University, Shenyang 110001, China

Received:2024-10-29 Accepted:2025-01-03 Published:2025-02-28 Online:2025-02-28
Contact: ZHAO Ning

摘要/Abstract

摘要：

颏下动脉穿支皮瓣（submental artery perforator flap，SMAPF）常应用于口腔及头颈颌面部肿瘤的术后缺损修复。本文报道了1例于中国医科大学附属第一医院耳鼻咽喉头颈外科治疗的泪囊癌累及眶内及鼻窦的患者，采用长血管蒂的SMAPF进行眶内容物摘除后的眼眶缺损修复，术后随访恢复良好，未见复发。

关键词: 颏下动脉穿支皮瓣, 眼眶缺损, 修复重建, 泪囊癌

Abstract:

Submental artery perforator flap (SMAPF) is often used for the repair of oral and maxillofacial defects after tumor resection. This paper presents a case of a patient with carcinoma of lacrimal sac involving the orbital cavity and nasal sinuses treated at the Department of Otorhinolaryngology-Head and Neck Surgery, the First Hospital of China Medical University. The patient underwent enucleation of orbital contents and repair of the eyecup defect using a long-vascular pedicle SMAPF, and the follow-up after surgery showed good recovery without recurrence.

Key words: submental artery perforator flap, orbital defect, repair and reconstruction, carcinoma of lacrimal sac

中图分类号:

R782
R739.8

于寒冰, 姜菲菲, 曹弘薇, 阎艾慧, 谭学新, 赵宁. 颏下动脉穿支皮瓣修复泪囊癌眼眶缺损1例报告及文献复习[J]. 《口腔颌面外科杂志》, 2025, 35(1): 75-78.

YU Hanbing, JIANG Feifei, CAO Hongwei, YAN Aihui, TAN Xuexin, ZHAO Ning. Submental artery perforator flap for repair of orbital defect of lacrimal sac carcinoma: A case report and literature review[J]. 《Journal of Oral and Maxillofacial Surgery》, 2025, 35(1): 75-78.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2025/V35/I1/75

图/表 5

图1 影像学资料 A.患者鼻窦冠状位CT示右侧眶内占位侵犯内直肌及鼻窦；B.鼻窦增强MRI冠状位示右侧眶内占位，右眼内直肌受压，右侧筛窦外侧壁受累。红色箭头示病变部位。

Figure 1 Patient's imaging data

图2 肿瘤切除及皮瓣制备 A.手术中切除泪囊癌及眶内容物；B.设计20 cm×7 cm的SMAPF；C、D.制备长血管蒂的SMAPF对眼眶缺损进行修补。

Figure 2 Tumor resection and flap preparation

图3 术中以SMAPF完成眼眶缺损修复

Figure 3 Orbital defect repaired with SMAPF

图4 肿瘤大体标本（包括眶内容一并摘除）

Figure 4 Gross tumor specimen (including orbital content)

图5 患者术后随访照 A.术后半年随访照；B.术后2年随访照。

Figure 5 Postoperative follow-up photographs of the patient

参考文献 12

[1]	Rahpeyma A, Khajehahmadl S. Submental artery island flap in intraoral reconstrucLion: A review[J]. J Craniomaxillofac Surg, 2014, 42(6): 983-989. doi: 10.1016/j.jcms.2014.01.020 pmid: 24581636
[2]	刘法昱, 孙长伏, 倪幼康, 等. 颏下动脉岛状皮瓣及穿支皮瓣在口腔颌面部缺损修复中的应用[J]. 中国实用口腔科杂志, 2017, 10(11): 652-656. doi: 10.19538/j.kq.2017.11.003
[3]	Tang ML, Ding MC, Almutairi K, et al. Three-dimensional angiography of the submental artery perforator flap[J]. J Plast Reconstr Aesthetic Surg, 2011, 64(5): 608-613.
[4]	Kim JT, Kim SK, Koshima I, et al. An anatomic study and clinical applications of the reversed submental perforator-based island flap[J]. Plast Reconstr Surg, 2002, 109(7): 2204-2210. doi: 10.1097/00006534-200206000-00004 pmid: 12045537
[5]	李再晔, 蒋灿华, 陈洁, 等. 带蒂穿支皮瓣修复口腔颌面部软组织缺损临床研究[J]. 中国实用口腔科杂志, 2017, 10(11): 657-661. doi: 10.19538/j.kq.2017.11.004
[6]	杨曦, 温树信, 王斌全, 等. 颏下翻转皮瓣修复声门上型喉癌术后咽瘘二例[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(12): 1045-1046.
[7]	Al Felasi MA, Bissada E, Ayad T. Reconstruction of an inferior orbital rim and cheek defect with a pedicled osteomyocutaneous submental flap[J]. Head Neck, 2016, 38(3): E64-E67.
[8]	黄龙, 郭峰, 翦新春, 等. 颏下动脉穿支皮瓣修复口腔癌术后缺损的临床应用[J]. 中华口腔医学杂志, 2018, 53(1): 3-7.
[9]	Krishna Y, Coupland SE. Lacrimal sac tumors—a review[J]. Asia Pac J Ophthalmol (Phila), 2017, 6(2): 173-178. doi: 10.22608/APO.201713 pmid: 28399337
[10]	Zhang R, Qian J, Meng FX, et al. A staged procedure in the treatment of primary lacrimal sac epithelial malignancy: A retrospective cases analysis[J]. Ophthalmic Plast Reconstr Surg, 2019, 35(2): 187-192.
[11]	Sittitrai P, Reunmakkaew D, Srivanitchapoom C. Submental island flap versus radial forearm free flap for oral tongue reconstruction: A comparison of complications and functional outcomes[J]. J Laryngol Otol, 2019, 133(5): 413-418. doi: 10.1017/S0022215119000744 pmid: 31006409
[12]	Hu S, Fan C, Pecchia B, et al. Submental island flap vs free tissue transfer in oral cavity reconstruction: Systematic review and meta-analysis[J]. Head Neck, 2020, 42(8): 2155-2164.

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颏下动脉穿支皮瓣修复泪囊癌眼眶缺损1例报告及文献复习

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颏下动脉穿支皮瓣修复泪囊癌眼眶缺损1例报告及文献复习

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