去上皮逆行面动脉-颏下动脉颏下岛状瓣修复上颌术后缺损

目的：探讨去上皮逆行面动脉-颏下动脉颏下岛状瓣对上颌骨术后缺损的修复效果。方法：回顾性研究我科自2007年3月-2009年1月应用去上皮逆行面动脉-颏下动脉颏下岛状瓣修复上颌骨术后缺损病例13例。其中男9例。女4例。所有病例均经病理学检查确诊，其中10例诊断为上颌牙龈鳞状细胞癌，其余3例诊断为硬腭鳞状细胞癌。依据Brown等提出的上颌骨缺损分类法，术后缺损为2a型．用以同期修复的面动脉-颏下动脉岛状瓣长度约8～10cm．宽度约4～5cm。结果：面动脉-颏下动脉岛状瓣的存活率为92.3％（12／13），未见供区并发症及面神经下颌缘支损伤。随访8～24个月．1例原发灶复发后死亡，2例颈淋巴结复发。结论：去上皮逆行面动脉-颏下动脉颏下岛状瓣具有安全、简单、易于改良等优点，适用于无区域性淋巴结转移的恶性肿瘤术后上颌骨缺损修复。

Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation

PURPOSE： The present study assessed the reliability of the reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects. METHODS： This study included 13 patients （9 men and 4 women; 43-62 years old） with maxillary defects resuhing from cancer ablation. Ten patients presented with maxillary gingival squamous cell carcinoma and the remaining 3 cases hard palatal squamous cell carcinomas.The maxilla was resected and the defects were classified as Class 2a. Reverse facial artery submental artery deepithelialised submental island flaps measuring 8-10 cm in length and 4-5 cm in width were used to reconstruct the defects. RESULTS： Twelve of the 13 flaps survived and the success rate was 92.3%. No donor site problems or palsy of the marginal mandibular branch of the facial nerve occurred. The follow up period ranged from 8 to 24 months, one patient died as a result of local tumour recurrence and two patients developed eervical lymph mode metastasis. CONCLUSION： The reverse facial artery submental artery deepithelialised submental island flap is safe, quick and simple to use or elevate. The flap is reliable for reconstructing maxillary defects following cancer ablation.