頦下島狀皮瓣修復早期口腔鱗狀細胞癌術后缺損_《中國修復重建外科雜志》

作者：

劉漢前 , 俞輝明 , 劉家武

南京醫科大學附屬淮安第一醫院口腔科（江蘇淮安，223300）;

關鍵詞：

頦下島狀皮瓣頜面部缺損修復口腔鱗狀細胞癌

DOI：

10.7507/1002-1892.20130240

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目的探討頦下島狀皮瓣修復早期口腔鱗狀細胞癌術后缺損的療效。方法2010年2月－2011年8月，收治15例早期口腔鱗狀細胞癌患者。男9例，女6例；年齡48～71歲，平均63歲。病程28～73 d，平均35 d。病變部位：舌3例，頰黏膜8例，磨牙后區2例，口底黏膜2例。根據2002版國際抗癌聯盟（UICC）口腔癌和口咽癌的TNM分期標準：T1N0M0 2例，T2N0M0 13例。病理分型：高分化鱗狀細胞癌11例，中等分化鱗狀細胞癌4例。病灶擴大切除后缺損范圍為5 cm × 3 cm～8 cm × 6 cm。1例因無明確回流靜脈改行游離前臂皮瓣修復，余14例均采用頦下島狀皮瓣修復，頦下島狀皮瓣切取范圍為6 cm × 4 cm～9 cm × 6 cm。結果14例采用頦下島狀皮瓣修復患者手術時間為4 h 30 min～7 h 10 min，平均5 h 53 min。術后13例皮瓣順利成活；1例皮瓣發生表層壞死，經保守治療后成活。1例發生暫時性面神經下頜緣支麻痹，3個月后逐漸恢復；3例發生頜下積液，對癥治療后愈合。14例均獲隨訪，隨訪時間8～15個月，平均10.5個月。2例男性患者皮瓣上有毛發生長，3個月后逐漸稀少。患者面部外形、開口度及吞咽和語音功能均恢復良好；頦下供區瘢痕不明顯。1例行游離前臂皮瓣修復患者隨訪13個月，外形及功能恢復良好。隨訪期間無局部復發。結論頦下島狀皮瓣血供恒定，制備簡便、快捷，可用于修復早期口腔鱗狀細胞癌術后缺損。

引用本文： 劉漢前,俞輝明,劉家武. 頦下島狀皮瓣修復早期口腔鱗狀細胞癌術后缺損. 中國修復重建外科雜志, 2013, 27(9): 1098-1101. doi: 10.7507/1002-1892.20130240 復制

1.	Vural E, Suen JY. The submental island flap in head and neck reconstruction. Head Neck, 2000, 22(6): 572-578.
2.	Martin D, Pascal JF, Baudet J, et al. The submental island flap: A new donor site: anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg, 1993, 92(5): 867-873.
3.	You YH, Chen WL, Wang YP, et al. The feasibility of facial-submental artery island myocutaneous flaps for reconstructing defects of the oral floor following cancer ablation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 109(6): e12-16.
4.	Paydarfar JA, Patel US. Submental island pedicled falps vs radical forearm free flap for oral reconstruction: comparisn of outcomes. Arch Otolaryngol Head Neck Surg, 2011, 137(1): 82-87.
5.	Wang JG, Chen WL, Ye HS, et al. Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation. J Craniomaxillofac Surg, 2011, 39(7): 499-502.
6.	Zhang B, Wang JG, Chen WL, et al. Reverse facial-submental artery island flap for reconstruction of oropharyngeal defects following middle and advanced-stage carcinoma ablation. Br J Maxillofac Surg, 2011, 49(3): 194-197.
7.	梁衍燦, 黃漢民, 陳偉良, 等. 面動脈-頦下動脈島狀皮瓣修復半舌缺損. 口腔頜面外科雜志, 2010, 20(4): 262-265.
8.	Curran AJ, Neligan P, Gullane PJ. Submental island flap. Laryngoscop, 1997, 107(11 Pt 1): 1545-1549.
9.	Higgins KM, Backstein R. The submental island flap: A regional and free flap with amyriad of reconstructive applications. J Otolaryngol, 2007, 36(2): 88-92.
10.	Sebastian P, Thomas S, Varghese BT, et al. Thesubmental island flap for reconstruction of intraoral defects in oral cancer patients. Oral Oncol, 2008, 44(11): 1014-1018.
11.	Faltaous AA, Yetman RJ. The submental artery flap: an anatomic study. Plast Reconstr Surg, 1996, 97(1): 56-60.
12.	張海明, 嚴義坪, 孫廣慈, 等. 頦下組織瓣的應用解剖學. 中華整形燒傷外科雜志, 1997, 13(4): 288-290.
13.	高銀光, 范飛, 尤建軍, 等. 頦下皮瓣的應用解剖學研究. 中國臨床解剖學雜志, 2006, 24(1): 54-56.
14.	Uppin SB, Ahmad QG, Yadav P, et al. Use of the submental island flap inorafacial reconstruction-a review of 20 cases. J Plast Reconstr Aesthet Surg, 2009, 62(4): 514-519.
15.	Pistre V, Pefissier P, Martin D, et al. The submental flap: its uses as a pedicled or free flap for facial reconstruction. Clin Plast Surg, 2001, 28(2): 303-309.
16.	Aboucbadi A, Capen-Degardin N, Patenotre P, et al. The submental flap in facial reconstruction: advantage and limitations. J Oral Maxillofac Surg, 2007, 65(5): 863-869.
17.	吳躍煌, 唐平章, 祁永發, 等. 頦下島狀皮瓣應用結果回訪. 中華口腔醫學雜志, 2002, 37(6): 418-420.
18.	Chen WL, Li JS, Yang ZH, et al. Two submental island flaps for reconstructing oral maxillofacial defects following cancer ablation. J Oral Maxillofac Surg, 2008, 66(6): 1145-1156.
19.	張翠翠, 王建廣, 樂志亮, 等. 頦下島狀肌皮瓣修復口腔頜面部缺損的臨床觀察. 中華耳鼻咽喉頭頸外科雜志, 2012, 47(4): 285-288.
20.	張繼生, 尹林, 卜壽山, 等. 原發灶對側血管蒂頦下島狀皮瓣修復口底區惡性腫瘤術后缺損的臨床應用. 江蘇醫學, 2011, 37(15): 1773-1774.
21.	潘孟雄, 馬祥偉, 覃小榮, 等. 原發灶對側頦下島狀皮瓣整復口腔頜面部缺損的臨床應用. 國際口腔醫學雜志, 2011, 38(1): 22-23, 26.

1. Vural E, Suen JY. The submental island flap in head and neck reconstruction. Head Neck, 2000, 22(6): 572-578.
2. Martin D, Pascal JF, Baudet J, et al. The submental island flap: A new donor site: anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg, 1993, 92(5): 867-873.
3. You YH, Chen WL, Wang YP, et al. The feasibility of facial-submental artery island myocutaneous flaps for reconstructing defects of the oral floor following cancer ablation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 109(6): e12-16.
4. Paydarfar JA, Patel US. Submental island pedicled falps vs radical forearm free flap for oral reconstruction: comparisn of outcomes. Arch Otolaryngol Head Neck Surg, 2011, 137(1): 82-87.
5. Wang JG, Chen WL, Ye HS, et al. Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation. J Craniomaxillofac Surg, 2011, 39(7): 499-502.
6. Zhang B, Wang JG, Chen WL, et al. Reverse facial-submental artery island flap for reconstruction of oropharyngeal defects following middle and advanced-stage carcinoma ablation. Br J Maxillofac Surg, 2011, 49(3): 194-197.
7. 梁衍燦, 黃漢民, 陳偉良, 等. 面動脈-頦下動脈島狀皮瓣修復半舌缺損. 口腔頜面外科雜志, 2010, 20(4): 262-265.
8. Curran AJ, Neligan P, Gullane PJ. Submental island flap. Laryngoscop, 1997, 107(11 Pt 1): 1545-1549.
9. Higgins KM, Backstein R. The submental island flap: A regional and free flap with amyriad of reconstructive applications. J Otolaryngol, 2007, 36(2): 88-92.
10. Sebastian P, Thomas S, Varghese BT, et al. Thesubmental island flap for reconstruction of intraoral defects in oral cancer patients. Oral Oncol, 2008, 44(11): 1014-1018.
11. Faltaous AA, Yetman RJ. The submental artery flap: an anatomic study. Plast Reconstr Surg, 1996, 97(1): 56-60.
12. 張海明, 嚴義坪, 孫廣慈, 等. 頦下組織瓣的應用解剖學. 中華整形燒傷外科雜志, 1997, 13(4): 288-290.
13. 高銀光, 范飛, 尤建軍, 等. 頦下皮瓣的應用解剖學研究. 中國臨床解剖學雜志, 2006, 24(1): 54-56.
14. Uppin SB, Ahmad QG, Yadav P, et al. Use of the submental island flap inorafacial reconstruction-a review of 20 cases. J Plast Reconstr Aesthet Surg, 2009, 62(4): 514-519.
15. Pistre V, Pefissier P, Martin D, et al. The submental flap: its uses as a pedicled or free flap for facial reconstruction. Clin Plast Surg, 2001, 28(2): 303-309.
16. Aboucbadi A, Capen-Degardin N, Patenotre P, et al. The submental flap in facial reconstruction: advantage and limitations. J Oral Maxillofac Surg, 2007, 65(5): 863-869.
17. 吳躍煌, 唐平章, 祁永發, 等. 頦下島狀皮瓣應用結果回訪. 中華口腔醫學雜志, 2002, 37(6): 418-420.
18. Chen WL, Li JS, Yang ZH, et al. Two submental island flaps for reconstructing oral maxillofacial defects following cancer ablation. J Oral Maxillofac Surg, 2008, 66(6): 1145-1156.
19. 張翠翠, 王建廣, 樂志亮, 等. 頦下島狀肌皮瓣修復口腔頜面部缺損的臨床觀察. 中華耳鼻咽喉頭頸外科雜志, 2012, 47(4): 285-288.
20. 張繼生, 尹林, 卜壽山, 等. 原發灶對側血管蒂頦下島狀皮瓣修復口底區惡性腫瘤術后缺損的臨床應用. 江蘇醫學, 2011, 37(15): 1773-1774.
21. 潘孟雄, 馬祥偉, 覃小榮, 等. 原發灶對側頦下島狀皮瓣整復口腔頜面部缺損的臨床應用. 國際口腔醫學雜志, 2011, 38(1): 22-23, 26.

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頦下島狀皮瓣修復早期口腔鱗狀細胞癌術后缺損

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