颏下岛状瓣修复口腔缺损的初步报告

旨在以颏下动脉和颏下静脉为血管蒂的颏下岛状瓣整复口腔缺损，方法７例口腔癌肿患者接受了口腔肿瘤切除加同颈淋巴清扫术，并同期行ＳＭＩＦ整复口腔，缺损，其中１例施行和根治性颈清扫术、１例施行了保留颈外静脉的改良颈清扫术，其余５例施行了保留颈内静脉的改良颈清扫术。     

颏下岛状瓣修复口腔组织缺损6例报告

目的:总结颏下岛状瓣修复口腔恶性肿瘤手术后缺损的临床效果。方法:回顾分析颏下带蒂岛状瓣转移修复口腔恶性肿瘤切除术后所致组织缺损的远期临床效果。结果:应用颏下带蒂岛状瓣修复口腔组织缺损6例,皮瓣全部成活,随访6个月,功能与外观满意。结论:颏下带蒂岛状瓣修复口腔组织缺损操作方便,成活率高,功能及形态恢复满意,是修复口腔肿瘤术后组织缺损的理想组织瓣。     

颏下岛状瓣修复口腔颌面部缺损应用进展

颏下岛状瓣是由面动脉-颏下动脉供血的轴型皮瓣,其制备简便,血供稳定,术后瘢痕隐蔽。自颏下岛状瓣开发以来,几经改良,用法灵活多样,一直受到口腔颌面外科、头颈外科、整形外科医生的青睐。目前,颏下岛状瓣已经广泛应用于口腔、口咽和面部缺损的修复,包括软腭、颧部、颞区等远处部位。颏下岛状瓣的广泛应用主要依赖于其血供特点,以及在此基础上的改良和血管蒂延长方法。文章就颏下岛状瓣的血供特点、皮瓣类型及改良、血管蒂延长方法以及在口腔颌面部缺损的创新性应用等做一综述,为临床医生选择颏下岛状瓣修复口腔颌面缺损提供全面的应用策略。     

颏下岛状瓣修复口腔颌面部缺损专家共识

颏下岛状瓣(submental island flap,SMIF)是面动脉分支颏下动脉恒定供血的轴型皮瓣,与口腔颌面部缺损区相邻,其质地、色泽与头面部相似,血运充分.该组织瓣制备较简单,且成活率高,适用于修复口腔颌面部中型缺损.然而,国内外对于SMIF的应用仍然存在争议,主要集中在颈淋巴转移患者使用该皮瓣的肿瘤安全性、...     

颏下岛状瓣修复口腔颌面部缺损临床应用研究--附30例报告

目的：评价颏下岛状瓣修复口腔颌面部组织缺损的临床效果及其价值,为临床应用提供经验。方法：临床应用颏下岛状瓣修复口腔颌面部缺损30例,其中面部6例,颊部9例（伴下唇缺损1例,口角缺损1例）,舌部9例,口底2例,磨牙后区1例,硬腭1例,上唇1例,下唇1例。术后观察组织瓣生长情况以及修复效果。结果：男性患者组织瓣上生长胡须,2例静脉回流障碍,1例组织瓣坏死,其余成活良好。缺损部位修复后,基本恢复解剖形态和生理功能。结论：颏下岛状瓣是修复口腔颌面部组织缺损的一种良好方法。     

颏下岛状瓣修复颊部肿瘤切除后组织缺损

目的：临床评价颏下岛状瓣修复颊黏膜组织缺损的应用价值。方法：10例颊黏膜、牙龈部位恶性肿瘤，扩大切除后形成的组织缺损以颏下岛状瓣修复，观察组织瓣存活情况及其修复效果。结果：颏下岛状瓣全部成活，未发生感染、坏死。保留全下颌骨者蒂部经过的部位表现丰满；2例瓣上胡须生长，其中1例诉说胡须引起局部不适。结论：颏下岛状瓣是一种修复颊部组织缺损的优良方法。     

颏下岛状瓣修复软腭及磨牙后区缺损

目的:探讨颏下岛状瓣修复软腭及磨牙后区缺损的临床应用价值。方法:26例软腭及磨牙后区恶性肿瘤扩大切除后,以颏下岛状瓣修复,术后评估皮瓣形态及功能恢复情况。结果:26例皮瓣中24例完全成活,2例坏死,供区均一期愈合。其中21例患者获得随访,5例失访,随访时间6~45个月,患者发音、吞咽等功能及皮瓣形态均恢复满意。随访期间均无局部复发。放射治疗期间,皮瓣均存活良好。结论:颏下岛状瓣是修复软腭及磨牙后区恶性肿瘤术后缺损较为理想的选择。     

颏下岛状瓣在口腔颌面部恶性肿瘤切除术后修复中的应用

目的:探讨颏下岛状瓣(submental artery island flap,SIF)在修复口腔及颌面部恶性肿瘤术后缺损中的临床应用价值.方法:回顾性地分析了2017年6月—2020年6月,我科颌面部恶性肿瘤手术切除后同期行颏下岛状瓣修复的患者资料,并以同期行血管化游离股前外侧肌皮瓣修复的患者作为对照组,两组共30例...     

颏下血管与颏下岛状瓣应用

颈部皮瓣色泽优良 ,因而 ,临床常用来整复面部软组织缺损。通常应用 3种类型的组织瓣 :随意瓣、颈阔肌肌皮瓣和锁骨上神经血管瓣。每一类型都存在着缺点。随意瓣移动受限 ,供区疤痕不可接受 ;颈阔肌肌皮瓣术后效果难以预测 ;而锁骨上神经血管瓣仅能达到面下 1 / 3区域 ,而且需要广泛分离组织以便于转位。　　颏下岛状瓣是整复口腔颌面部组织缺损又一新的手段 ,且优点较多。自 1 993年Martin等[1 ] 报道以来 ,国内外学者在颏下岛状瓣的应用解剖学方面进行了深入的研究 ,在临床应用方面作了广泛的探讨 ,就这一问题的现状作一简介。1　颏下血…     

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目的探讨应用颏下岛状皮瓣修复颊部软组织缺损的效果。方法对1999年6月至2010年9月南通大学附属医院口腔颌面外科收治的26例颊部软组织缺损病例(恶性肿瘤术后颊部软组织缺损22例,车祸外伤所致的颊部软组织缺损4例),应用颏下岛状皮瓣即刻修复,所采用组织瓣面积最大8cm×4cm,最小6cm×3cm。从功能恢复与缺损形态恢复的满意度评价术后修复效果。结果 26例皮瓣均完全成活,其中25例面部形态满意,1例外观欠佳。结论颏下岛状皮瓣是修复颊部软组织缺损的有效方法。     

Submental artery island flap in intraoral reconstruction: A review

BackgroundThe submental flap was first introduced 20 years ago (1993). Advances in techniques and new findings from anatomic studies expanded the indications and improved the flap characteristics. Indications, limitation, and all possible variants of this flap are discussed comprehensively in this article.Materials and methodsA literature review was performed. We paid attention to the anatomy of submental region, and especially to submental artery and vein, muscles and lymphatics. Surgical techniques for each possible variant of this flap and examples of each situation are presented. Indications of submental flap for facial, oesophageal, pharyngeal, laryngeal, and oral cavity reconstruction were assessed.ResultsNinety studies meeting the inclusion criteria were reviewed. Classification of the submental flap based on skin paddle composition and blood supply is presented. Major modifications such as pedicled, free, and perforator flaps are discussed comprehensively and minor variants of submental flap such as bipaddled, bipedicled, expanded, deepithelialized, and interposition submental flaps are discussed, briefly. A historical look at this topic is presented to show how and by whom advances in submental flap were done.ConclusionThe submental flap has a wide arc of rotation; it is easy to rise and has low donor site morbidity. It is a safe, simple, and predictable method for reconstruction of oral cavity.     

Outcomes of younger and older patients with palatal cancer undergoing pedicled facial-submental artery island flap reconstruction

The purpose of this study was to evaluate the outcomes of younger and older patients with palatal cancer undergoing reconstruction using the pedicled facial-submental artery island flap (FSAIF) following cancer ablation. Fifty-eight patients with palatal squamous cell carcinoma (SCC) were divided into two age groups: ≤60 years (n = 31) and >60 years (n = 27). By clinical SCC stage, 6.4%, 83.9%, and 9.7% of the younger group and 3.7%, 85.2%, and 11.1% of the older group were stage I, II, and III, respectively. The incidence of comorbid conditions was 35.5% (11/31) in those ≤60 years and 137.0% (37/27) in those >60 years. Brown class II maxillary defects (four class IIa, 44 class IIb, three class IIc, and seven class IId) were repaired using FSAIFs following cancer ablation. There were two flap failures; thus the success rate was 96.6%. Significant differences in mean age and the incidence of comorbid conditions were evident between the groups. No significant differences in TNM stage, maxillary defect classification, flap size, overall flap survival, rates of local and general complications, or survival status was evident between the groups. The FSAIF is a reliable and safe method for repairing Brown class II maxillary defects following cancer ablation, particularly in older patients.     

面动脉-颏下动脉岛状肌皮瓣修复颊黏膜缺损（附13例报告）

目的：评价面动脉-颏下动脉岛状肌皮瓣（FSF）修复颊癌术后颊黏膜缺损的临床效果。方法：13例颊黏膜鳞状细胞癌手术切除后颊黏膜组织缺损,用FSF修复。本组病例中,男8例,女5例;平均年龄58.5岁;T2N0M0期7例,T3N0M0期6例。皮瓣大小为4.0 cm×8.0 cm～5.0 cm×10.0 cm。结果：面动脉-颏下动脉岛状肌皮瓣修复颊黏膜缺损手术成功率92.3%（12/13）。全部病例经12～24个月复查,受区功能正常,供区外形良好,有1例颈部肿瘤复发。结论：FSF适用于修复中型颊黏膜缺损。     

颏下岛状皮瓣在修复舌癌术后缺损中的临床应用

目的:探讨颏下岛状皮瓣在修复舌癌术后组织缺损中的临床应用价值。方法:利用5具经10%甲醛溶液固定的国人成人男性标本,对颏下动脉相关解剖进行观测,并结合我院2005-09—2008-06使用颏下岛状皮瓣修复的9例舌癌患者进行临床回顾性分析。结果:颏下动脉走行恒定。9例颏下岛状皮瓣均成活,2例皮瓣远端表面部分坏死。修复后的舌黏膜表面光滑,运动受限不明显,吞咽功能良好。结论:颏下岛状皮瓣供血血管恒定,制备简单,成活率高,供区并发症少,且能够耐受放疗,是修复舌癌术后组织缺损较理想的皮瓣。     

延长颏下动脉穿支皮瓣血管蒂修复口腔颌面部缺损的临床应用

目的:本研究通过延长颏下动脉穿支皮瓣(submental artery perforator flap,SMAPF)血管蒂的3种方法修复口腔颌面部距供区较远的缺损,并对其可行性及临床效果评价.方法:选取自2019年1月—2021年2月于中国医科大学附属口腔医院颌面头颈肿瘤外科就诊并收治,行同侧颏下动脉穿支皮瓣手术修复口...     

舌正中岛状瓣修复口底缺损

目的：总结应用舌正中岛状瓣修复口底缺损的经验。方法：5例中小型口底缺损患者采用舌正中岛状瓣修复重建。在舌背正中部位制备舌肌黏膜瓣,通过切开舌尖或舌组织隧道以岛状瓣的方式转移修复口底缺损。结果：5例患者术后舌瓣均成活良好,无舌瓣坏死,1例术后一侧舌尖部分坏死。术后随访3-6个月,患者发音及吞咽功能无明显异常。结论：舌正中岛状瓣是一种修复中小型口底缺损的好方法。     

The submental island flap: Pedicle elongation and indications in head and neck reconstruction

BackgroundThe submental island flap is an axial pattern skin flap first described by Martin et al. in 1993. When used to reconstruct skin defects it matches the recipient site in terms of colour, texture and thickness. One of the main limitations to its application is the arc of the pedicle allowing coverage of only the lower two thirds of the face.MethodsA retrospective review was performed of all patients who had had a submental island flap reconstruction at the Operative Unit of Maxillo-Facial Surgery of the University Hospital of Parma, Italy, between 2001 and 2011.The Authors focused on the surgical technique adopted, the clinical indications and the results obtained. They analysed the different ways to elongate the pedicle and discuss their thoughts on the choice of reconstruction. A flowchart was created to help in the decisional process.ResultsBetween 2001 and 2011 the submental island flap was used to reconstruct head and neck defects in 22 patients. Thirteen patients had defects of the oral cavity; the remaining 9 patients had skin defects involving the pre-auricular region, the temporal area and the peri-nasal cheek skin.No major complications occurred and in one case a partial necrosis of the distal portion of the flap was observed. Five patients underwent surgical revision involving intraoral flap debulking 6–10 months after the primary procedure.Discussion and conclusionsThe techniques to elongate the pedicle used and described were: additional dissection of the pedicle, Y–V procedure, reverse flow flap, section of facial vein and microvascular anastomosis. Their choice is mainly conditioned by the site of the defect.     

颏下岛状皮瓣的解剖研究及临床应用进展

颏下岛状皮瓣于1993年由Martin等[1]首先报道。该皮瓣颜色、质地与面部组织十分相似、外观自然;皮瓣蒂长、旋转范围大;可提供的皮肤组织量大;血供稳定、成活率高;供区隐蔽,可以一期缝合;而且操作较为简单,手术及住院时间短,目前已成为修复头颈部缺损的重要皮瓣之一。本文现将该