運用頦下皮瓣於早期口腔癌術中口腔缺損重建

The Submental Flap for Reconstruction of the Oral Cavity Defects in Early Oral Cancer

何嘉哲(Chia-Che Ho) ； 鍾從得(Tsung-Te Chung) ； 林睿禹(Jui-Yu Lin) ； 蕭舜仁(Shun-Jen Hsiau)

《台灣耳鼻喉頭頸外科雜誌》 48卷3期 (2013/09) Pp. 205-210

https://doi.org/10.6286/2013.48.3.205

摘要

背景：運用頦下皮瓣於早期口腔癌術中口腔缺損重建，探討其可行性。方法：採回溯性分析，收集彰化秀傳醫院2008年01月至2012年05月間接受頦下皮瓣重建之早期口腔癌病人。記錄病人性別、年齡、腫瘤大小及位置、腫瘤分期、手術方式、術後併發症、追蹤時間、皮瓣狀況及供區外觀、有無腫瘤局部區域復發、生活品質情況。結果：共9名男病人，年齡分布從37到83歲。腫瘤大小從0.5 × 1.5到4 × 4 cm，口腔底癌1例、頰癌2例、下牙齦癌3例、舌癌3例，臨床分期第一期2例、第二期7例，均接受腫瘤廣泛性切除、同側頸部淋巴廓清術、及頦下皮瓣重建，皮瓣大小從3.0 × 6.5到4 × 10 cm。術後皮瓣均存活且無皮瓣供區併發症，無顏面神經下頷緣分支麻痺，1例皮瓣部分壞死合併膿瘍，1例皮瓣重建處血腫。追蹤4到56個月，頦下皮瓣及皮瓣供區外觀良好，無腫瘤局部區域復發，且生活品質改善。結論：頦下皮瓣對早期口腔癌術中口腔缺損重建是一個可行且多優點的方法。

關鍵字

頦下皮瓣 ； 口腔缺損 ； 頭頸部重建 ； 口腔癌

並列摘要

BACKGROUND: The submental flap is gaining acceptance as a simple and reliable option in reconstruction of oral cavity defects after oral cancer surgery. This study aims to assess the usefulness of submental flap in reconstruction of oral cavity defects after oral cancer surgery with respect to flap reliability, cosmesis, quality of life and oncological safety.METHODS: Nine patients who underwent surgery and reconstruction using the submental flap for early oral cancer at Changhua Show Chwan Hospital between January 2008 and May 2012 were retrospectively studied for the flap reliability, cosmesis, quality of life and locoregional recurrence. The site and stage of the tumor, surgery procedure, and postoperation complications were recorded and the patients were followed up to assess the status of the flap, the quality of life and the oncologic outcomes.RESULTS: There were 9 patients whose ages ranged from 37 years to 83 years included in the analysis. All patients underwent submental flap reconstruction after neck dissection along with the wide excision of the tumor. The size of the submental flaps ranged from 3.0 × 6.5 to 4 × 10 cm. All flaps survived without donor site complications. No marginal mandibular branch of the facial nerve paralysis was observed. Two complications were recorded: one had partial loss of the submental flap with abscess and the other had hematoma under the submental flap. The follow up period ranged from 4 to 56 months. All patients had satisfactory cosmetic results and better quality of life. There was no locoregional recurrence of the tumor.CONCLUSIONS: The submental flap is a reliable option for reconstruction of oral cavity defects in early oral cancer patients, with limited complications, acceptable cosmetic results, quality of life and reasonable oncological outcome.

並列關鍵字

submental flap ； oral cavity defects ； head and neck reconstruction ； oral cancer