颏下岛状瓣修复舌癌切除术后舌与口底组织缺损

目的评价颏下岛状瓣修复舌组织缺损的临床效果及其应用价值。方法1997年3月~2004年10月,对9例舌癌患者在行舌颌颈联合根治术后所形成的舌或舌与口底组织缺损,应用颏下岛状瓣修复。其中男6例,女3例,年龄48~71岁。右半侧舌5例,左半侧舌4例,其中病变侵及口底者4例。组织缺损范围4.2 cm×3.2 cm~5.5 cm×4.0 cm。修复所用组织瓣大小为6.0 cm×3.0 cm~7.0 cm×4.0 cm。以颏下动脉为蒂8例,颏下动脉联合颌外动脉近心端为蒂1例。结果术后8例颏下岛状瓣成活。修复后舌体静态形态佳;动态表现前伸、上举、侧向运动不受限,语音清晰,吞咽功能良好,未发生任何并发症。3例术后3周放疗。随访1~36个月,舌无异常变化。1例组织瓣坏死脱落,创面自然愈合。结论颏下岛状瓣修复舌缺损,手术方法简便,并能提供足量组织同时修复口底缺损。

REPAIRING DEFECTS OF TONGUE AND MOUTH FLOOR WITH SUBMENTAL ISLAND FLAP AFTER TUMOR SURGERY

OBJECTIVE: To evaluate the clinical significance of submental island flap in repairing tongue defects. METHODS: Nine patients (6 men and 3 women) with tongue squamous cell carcinoma underwent subtotal or partial glossectomy, resection of mandible, radical neck dissection and immediate reconstruction of tongue defects with submental island flap. The age ranged from 48 years to 71 years, the lesion locations were right part of tongue (5 cases) and left part of tongue (4 cases). The defect sizes were 4.2 cm x 3.2 cm to 5.5 cm x 4.0 cm. The flap area ranged from 6.0 cm x 3.0 cm to 7.0 cm x 4.0 cm. The flap pedicle included submental artery in 8 cases and both submental artery and facial artery in 1 case. RESULTS: The submental island flap survived in 8 cases. Postoperative articulation and swallowing were investigated in all cases. The static shape of tongue after reconstruction with submental island flap was acceptable. The dynamic speech, swallowing and food transport function were well preformed. No complication occurred. Three patients were given radiotherapy 3 weeks after operation. CONCLUSION: It is simple and convenient to repair defects of tongue and oral floor with submental island flap.