面颏下动脉岛状皮瓣在口腔与口咽鳞状细胞癌切除术后重建的临床效果比较  

Comparison of the clinical effect of a facial-submental artery island flap in reconstruction after resection of oral cavity and oropharyngeal squamous cell carcinoma

作　　者：袁开放 陈伟良[1] 周斌[1] 张大明[1] YUAN Kaifang;CHEN Weiliang;ZHOU Bin;ZHANG Daming(Department of Oral and Maxillofacial Surgery,Sun Yat⁃sen Memorial Hospital of Sun Yat⁃sen University,Guangzhou 510000,China)

机构地区：[1]中山大学孙逸仙纪念医院口腔颌面外科

出　　处：《口腔疾病防治》2020年第2期84-87,共4页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目（81772888;81702695）

摘　　要：目的比较口腔鳞状细胞癌(oral cavity squamous cell carcinoma,OC⁃SCC)和口咽鳞状细胞癌(oropha⁃ryngeal squamous cell carcinoma,OP⁃SCC)切除后应用面颏下动脉岛状皮瓣(facial⁃submental artery island flap,FSAIF)重建术区缺损的临床效果。方法203例原发部位为口腔的鳞状细胞癌、72例口咽鳞状细胞癌患者根治术后,以FSAIF修复术后缺损,观察术后两组皮瓣的并发症及成功率,评估比较术后6个月时两组患者吞咽、语音功能,并随访两组患者生存情况。结果OC⁃SCC组与OP⁃SCC组在TNM分期、皮瓣的皮岛大小、皮瓣成活率、局部并发症等方面的差异无统计学意义(P>0.05)。OC⁃SCC组吞咽及语音结果优于OP⁃SCC组,差异有统计学意义(P<0.05)。两组随访9~59个月的生存结果差异无统计学意义(P>0.05)。结论FSAIF可用于口腔和口咽癌术后缺损重建,但重建口咽癌术后缺损吞咽功能较差。Objective To compare the clinical effect of the reconstruction of defects of the surgical area with the fa⁃cial⁃submental artery island flap(FSAIF)after resection of oral cavity squamous cell carcinoma(OC⁃SCC)and oropha⁃ryngeal squamous cell carcinoma(OP⁃SCC).Methods A total of 203 cases of oral cavity squamous cell carcinoma and 72 cases of oropharyngeal squamous cell carcinoma were treated with the FSAIFs.The complications and success rate of the two groups were observed.The swallowing and voice functions of the two groups were evaluated and compared 6 months after the operation.The survival of the two groups was followed up.Results No significant differences were found in TNM stage,the skin paddle of the flap,the rate of flap failure,or local complications between the OC⁃SCC and OP⁃SCC groups(P>0.05).Significant differences in swallowing and speech outcomes were observed between the groups(P<0.05).No significant differences were found in survival outcome between the groups after 9⁃59 months of fol⁃low⁃up.Conclusion FSAIF can be used for reconstructing the defect in oral cavity or oropharynx,but the swallowing function of reconstructing the defect in oropharynx is poor.

关 键 词：口腔 口咽 鳞状细胞 癌 肿瘤 术后缺损 面颏下动脉岛状皮瓣 带蒂皮瓣 功能修复 吞咽功能 言语功能 预后 

分 类 号：R782.2[医药卫生—口腔医学]