面动脉-颏下动脉岛状瓣修复65例腭癌术后BrownⅡ类缺损的疗效评价

目的：比较使用面动脉-颏下动脉岛状瓣（facial-submental artery island flap,FSAIF）同期修复年轻或老年腭癌患者肿瘤术后BrownⅡ类缺损的疗效。方法：65例腭部鳞状细胞癌患者,肿瘤术后缺损采用FSAIF修复。患者按年龄分为2组—年轻组（≤60岁）35例,老年组（> 60岁）30例。2组患者心脑血管等其他疾病的比例分别为37.1%（13/35）和156.7%（47/30）。临床分期包括Ⅰ、Ⅱ和Ⅲ期,年轻组分别为8.6%、85.7%和5.7%,老年组分别为6.7%、86.7%和6.7%。采用SPSS 20.0软件包对数据进行χ²检验、独立样本t检验和Mann-Whitney U检验,分析组间数据差异。结果：65例Brown Ⅱ类上颌骨缺损中,Ⅱa类4例,Ⅱb 49例,Ⅱc 5例和Ⅱd 7例。皮瓣成活率为96.9%（63/65）。老年组伴发疾病的几率显著高于年轻组（P<0.05）。2组间在性别、TNM分期、上颌骨缺损类型、皮瓣大小、皮瓣总存活率、局部或全身并发症发生率、生存状态方面无显著差异（P>0.05）。结论：面动脉-颏下动脉岛状瓣修复老年腭癌患者肿瘤术后BrownⅡ类缺损,是一种安全可靠的方法。

Clinical outcomes of 65 patients with palatal cancer ablation following facial-submental artery island flap reconstruction of Brown class II maxillary defects

PURPOSE: To evaluate the outcomes of younger and older patients with palatal cancer undergoing reconstruction using facial-submental artery island flap (FSAIF) following cancer ablation. METHODS: Sixty-five patients with palatal squamous cell carcinoma (SCC) were divided into two age groups: ≤60(n=35) and >60 years(n=30). The clinical SCC stages wereⅠ,Ⅱand Ⅲ in 8.6%, 85.7% and 5.7% of the younger group, 6.7%, 86.7% and 6.7% of the older group. The incidences of comorbid conditions were 37.1%（13/35） and 156.7%(47/30), respectively. Statistical analysis was performed using SPSS 20.0 software package. RESULTS: Brown class Ⅱ maxillary defects, including classes Ⅱa (n=4), Ⅱb (n=49), Ⅱc (n=5), and Ⅱd (n=7), were reconstructed using FSAIFs following cancer ablation. There were two flap failures, thus the success rate was 96.9%. Significant differences in age and the incidence of comorbid conditions were evident between the two groups. There was no significant difference in sex, TNM stage, maxillary defect classification, flap size, overall flap survival, the rate of local or general complications, or survival status between the two groups. CONCLUSIONS: FSAIF is a reliable and safe method for reconstructing Brown class II maxillary defects following cancer ablation, particularly in older patients.