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@#The facial submental artery island flap (FSAIF) is a fasciocutaneous flap supplied by the facial submental artery. It is in close proximity with many oral and maxillofacial regions, and its tex ture and color are similar to those of the head and face. The flap has a constant and sufficient blood supply, and it is easy to prepare and has high survival rates and few complications. According to the tissue carried, FSAIF can be divided into fasciocutaneous flaps, myocutaneous flaps and simple flaps. The flap can also be made into an osteofasciocutaneous (myocutaneous) flap with a mandible to repair maxillary defects. Because this flap is a pedicled flap, it can greatly shorten the operation time, bed rest time and hospitalization time and has been widely used in repairing medium-sized defects of the oral and maxillofacial region. The indications for FSAIF in repairing maxillofacial defects should be strictly controlled. It can be safely used for benign or malignant tumors without cervical lymph node metastasis. For malignant tumors with cervical lymph node metastasis but without extranodal extension, the flap can be used on the premise of thorough neck dissection. The contraindication is cervical lymph node metastasis and extranodal extension of malignant tumors; therefore, other flaps should be selected for repair.
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ObjectiveReconstruction of oral and maxillofacial defects following resection of oral and maxillofacial malignant tumors is required to restore the patient's appearance and oral function. The aim of this study was to evaluate the application and value ofsoleus perforator flap from the lateral leg in repair of oral and maxillofacial defects.MethodsIn this retrospective study, ten patients with oral and maxil-lofacial malignancies who were admitted to the Department of Oral and Maxillofacial Surgery in Fuyang People's Hospital during the period from May 2015 to March 2019 were enrolled. The effect of soleus perforator flap from the lateral leg was ana-lyzed.At 1 month and 3 months after surgery, the recovery of oral function and donor sites, quality of life and surgical satisfaction were followed.ResultsAllpatients underwent operation successfully without skin flap necrosis or serious complications.At 3 months after surgery,voice function and swallowing func-tion were level 3. The scar hyperplasia was 1 case,donor itching1 case and paresthesia or dysfunction 0 case.Compared with those at 1 month after surgery, the scores at 3 months after surgery were increased using the University of Washington Quality of Life (UW-QOL) questionnaire(P<0.05). At 1 month and 3 months after sur-gery,patient satisfaction rateswere 80.00% and 90.00%, respectively.ConclusionThe soleus perforator flap from the lateral leg isideal for repairing oral and maxillofacial defects. The postoperative recovery of oral functio-nand donor sites is goodwith high quality of life and surgical satisfaction.
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Objective To compare and analyze the advantages and disadvantages of the forearm skin flap and the lateral femoral skin flap in the repair of oral and maxillofacial defects.Methods Of the 34 patients of oral and maxillofacial tumor resection received postopera-tive reconstruction of maxillofacial defects treatment,18 patients repaired by forearm flap( forearm flap group) ,16 patients repaired by antero-lateral thigh flap ( anterolateral thigh flap group) .The clinical effect and the restoration of two groups after surgery were compared.Results The survival rate of disposable surgical flap in forearm flap group was 94.44%,the survival rate of the anterolateral thigh flap group was 87.50%.The difference between two groups was not statistically significant (P>0.05).The difference of swallowing function in 3 months after surgery between two groups was not statistically significant (P>0.05).The difference of survival quality score between the two groups was not statistically significant (P >0.05) in 6 months after surgery.The scar proliferation rate (27.78%), pigment deposition rate (88.89%), temporary sexual dysfunction rate(66.67%),a permanent disability rate (27.78%) of forearm flap group were significantly higher than those of the femoral anterolateral flap group patients (P<0.05).Conclusion The forearm skin flap and the lateral femoral skin flap have a good clincal effect on the repair of oral and maxillofacial defects,and the incidence of complications of the femoral anterior lateral femoral flap is lower.
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Objective To investigate the clinical application of free submental flap for defects reconstruction after oral cancer ablation.Methods Eleven cases of free submental flaps for defects reconstruction after oral cancer ablation from April,2013 to May,2014 were reviewed.The primary disease,defect type,flap side,flap size and flap survival rate were recorded.The follow-up data of tumor recurrence,lymph node metastasis,as well as postoperative facial appearance and function of marginal mandibular branch of facial nerve were collected.Results Primary disease of all 11 cases was oral squamous cell carcinoma.No flap failure was reported and the overall flap survived.The follow-up period was 6-18 months with the average of 9 months.There was no tumor recurrence and metastasis of lymph node.Postoperative facial appearance was satisfactory and there was no nerve injury of marginal mandibular branch which showed normal and symmetrical expression motion.Conclusion Free submental flap owns many ad vantages including constant anatomy,long vascular pedicle,wide range of indications and low donor-site morbidity.Contralater submental flap may avoid potential lymph node metastasis.Free submentai flaps is an ideal choice for reconstruction of oral and maxillofacial defects after cancer ablation.