颏下岛状皮瓣修复早期口腔鳞状细胞癌术后缺损_《中国修复重建外科杂志》

作者：

刘汉前 , 俞辉明 , 刘家武

南京医科大学附属淮安第一医院口腔科（江苏淮安，223300）;

关键词：

颏下岛状皮瓣颌面部缺损修复口腔鳞状细胞癌

DOI：

10.7507/1002-1892.20130240

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的探讨颏下岛状皮瓣修复早期口腔鳞状细胞癌术后缺损的疗效。方法2010年2月－2011年8月，收治15例早期口腔鳞状细胞癌患者。男9例，女6例；年龄48～71岁，平均63岁。病程28～73 d，平均35 d。病变部位：舌3例，颊黏膜8例，磨牙后区2例，口底黏膜2例。根据2002版国际抗癌联盟（UICC）口腔癌和口咽癌的TNM分期标准：T1N0M0 2例，T2N0M0 13例。病理分型：高分化鳞状细胞癌11例，中等分化鳞状细胞癌4例。病灶扩大切除后缺损范围为5 cm × 3 cm～8 cm × 6 cm。1例因无明确回流静脉改行游离前臂皮瓣修复，余14例均采用颏下岛状皮瓣修复，颏下岛状皮瓣切取范围为6 cm × 4 cm～9 cm × 6 cm。结果14例采用颏下岛状皮瓣修复患者手术时间为4 h 30 min～7 h 10 min，平均5 h 53 min。术后13例皮瓣顺利成活；1例皮瓣发生表层坏死，经保守治疗后成活。1例发生暂时性面神经下颌缘支麻痹，3个月后逐渐恢复；3例发生颌下积液，对症治疗后愈合。14例均获随访，随访时间8～15个月，平均10.5个月。2例男性患者皮瓣上有毛发生长，3个月后逐渐稀少。患者面部外形、开口度及吞咽和语音功能均恢复良好；颏下供区瘢痕不明显。1例行游离前臂皮瓣修复患者随访13个月，外形及功能恢复良好。随访期间无局部复发。结论颏下岛状皮瓣血供恒定，制备简便、快捷，可用于修复早期口腔鳞状细胞癌术后缺损。

引用本文： 刘汉前,俞辉明,刘家武. 颏下岛状皮瓣修复早期口腔鳞状细胞癌术后缺损. 中国修复重建外科杂志, 2013, 27(9): 1098-1101. doi: 10.7507/1002-1892.20130240 复制

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.	梁衍灿, 黄汉民, 陈伟良, 等. 面动脉-颏下动脉岛状皮瓣修复半舌缺损. 口腔颌面外科杂志, 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.	张海明, 严义坪, 孙广慈, 等. 颏下组织瓣的应用解剖学. 中华整形烧伤外科杂志, 1997, 13(4): 288-290.
13.	高银光, 范飞, 尤建军, 等. 颏下皮瓣的应用解剖学研究. 中国临床解剖学杂志, 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.	吴跃煌, 唐平章, 祁永发, 等. 颏下岛状皮瓣应用结果回访. 中华口腔医学杂志, 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.	张翠翠, 王建广, 乐志亮, 等. 颏下岛状肌皮瓣修复口腔颌面部缺损的临床观察. 中华耳鼻咽喉头颈外科杂志, 2012, 47(4): 285-288.
20.	张继生, 尹林, 卜寿山, 等. 原发灶对侧血管蒂颏下岛状皮瓣修复口底区恶性肿瘤术后缺损的临床应用. 江苏医学, 2011, 37(15): 1773-1774.
21.	潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧颏下岛状皮瓣整复口腔颌面部缺损的临床应用. 国际口腔医学杂志, 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. 梁衍灿, 黄汉民, 陈伟良, 等. 面动脉-颏下动脉岛状皮瓣修复半舌缺损. 口腔颌面外科杂志, 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. 张海明, 严义坪, 孙广慈, 等. 颏下组织瓣的应用解剖学. 中华整形烧伤外科杂志, 1997, 13(4): 288-290.
13. 高银光, 范飞, 尤建军, 等. 颏下皮瓣的应用解剖学研究. 中国临床解剖学杂志, 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. 吴跃煌, 唐平章, 祁永发, 等. 颏下岛状皮瓣应用结果回访. 中华口腔医学杂志, 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. 张翠翠, 王建广, 乐志亮, 等. 颏下岛状肌皮瓣修复口腔颌面部缺损的临床观察. 中华耳鼻咽喉头颈外科杂志, 2012, 47(4): 285-288.
20. 张继生, 尹林, 卜寿山, 等. 原发灶对侧血管蒂颏下岛状皮瓣修复口底区恶性肿瘤术后缺损的临床应用. 江苏医学, 2011, 37(15): 1773-1774.
21. 潘孟雄, 马祥伟, 覃小荣, 等. 原发灶对侧颏下岛状皮瓣整复口腔颌面部缺损的临床应用. 国际口腔医学杂志, 2011, 38(1): 22-23, 26.

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《中国修复重建外科杂志》

颏下岛状皮瓣修复早期口腔鳞状细胞癌术后缺损

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