颏下岛状皮瓣修复口腔颌面部恶性肿瘤扩大切除术后软组织缺损的临床效果观察  

Observation of the clinical effect of submental island flap in repairing soft tissue defects after extended resection of malignant tumors in the oral and maxillofacial region

作　　者：张宏[1] 王军[1] 邵蓉 范向达[1] ZHANG Hong;WANG Jun;SHAO Rong(Gansu Provincial Cancer Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省肿瘤医院,730050

出　　处：《中国实用医药》2025年第7期33-37,共5页China Practical Medicine

基　　金：国家临床重点专科建设项目资金支持(项目编号:甘财社(2021)80号);甘肃省科技计划项目:甘肃省头颈肿瘤临床医学研究中心(项目编号:21JR7RA678)。

摘　　要：目的探讨颏下岛状皮瓣修复口腔颌面部恶性肿瘤扩大切除术后软组织缺损的疗效。方法20例因口腔颌面部恶性肿瘤扩大切除术后需行颏下岛状皮瓣修复缺损患者为研究对象,观察患者术后颏下岛状皮瓣成活率,评估供区及受区的功能恢复情况、肿瘤复发情况。结果20例患者的颏下岛状皮瓣全部成活,颏部供区均一期拉拢缝合,术后每3个月~半年复查1次,颏部供区均恢复良好。其中1例牙龈癌术后1年出现颈部淋巴结转移,给予再次清扫颈部淋巴结手术后,到本院放疗科行放疗治疗;1例舌癌患者术后病理提示颈部Ⅱ区有1枚淋巴结转移,术后半年出现口底复发及颈部淋巴结转移,到本科给予免疫+化疗治疗(替雷利珠单抗+白蛋白紫杉醇+顺铂),化疗后行放疗治疗。结论颏下岛状皮瓣因其血管蒂稳定,对供区伤害小,且皮瓣成活率高,适用于术前检查颈部Ⅰ区无淋巴结转移的早期口腔癌或颌面部良性肿瘤切除术后的缺损修复,但术前检查已有颈部淋巴结转移的患者不建议使用此皮瓣。Objective To explore the efficacy of submental island flap in repairing soft tissue defects after extended resection of malignant tumors in the oral and maxillofacial region.Methods 20 patients who underwent extended resection of malignant tumors in the oral and maxillofacial region and required submental island flaps for defect repair were selected as study subjects.The survival rate of submental island flap was observed,and the functional recovery of donor and recipient areas and tumor recurrence were evaluated.Results All 20 patients'submental island flaps survived,and the chin donor site was sutured in stageⅠ.After surgery,the chin donor site was rechecked every 3 months-6 months,and the recovery was good.Among them,1 case of gingival cancer developed cervical lymph node metastasis 1 year after surgery,and was given another surgery to clear cervical lymph nodes,and then went to Radiotherapy Department for radiotherapy treatment;1 case of tongue cancer patient had 1 lymph node metastasis in the neckⅡarea after surgery,and developed mouth floor recurrence and cervical lymph node metastasis half a year after surgery,and was given immune+chemotherapy therapy(tislelizumab+paclitaxel-albumin+cisplatin),and was treated with radiotherapy after the chemotherapy.Conclusion The submental island flap,due to its stable vascular pedicle,minimal damage to the donor site,and high survival rate,is suitable for defect repair after preoperative examination of early oral cancer in neck area partⅠor benign tumors in the maxillofacial region without lymph node metastasis.However,it is not recommended for patients with cervical lymph node metastasis detected before surgery.

关 键 词：颏下岛状皮瓣 修复 软组织缺损 

分 类 号：R739.8[医药卫生—肿瘤]