华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (2): 204-209.doi: 10.7518/hxkq.2022.02.012

• 临床研究 • 上一篇    下一篇

血管化黏膜瓣在早-中期舌癌及口底癌缺损修复中的早期应用研究

蒋悦赟1(), 唐菱菱2, 马中凯1, 刘伟1, 黄能文1, 李春洁1()   

  1. 1.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院头颈肿瘤外科,成都 610041
    2.安顺市人民医院口腔颌面外科,安顺 561000
  • 收稿日期:2021-09-24 修回日期:2022-01-31 出版日期:2022-04-01 发布日期:2022-04-01
  • 通讯作者: 李春洁 E-mail:734302884@qq.com;lichunjie@scu.edu.cn
  • 作者简介:蒋悦赟,硕士,E-mail:734302884@qq.com
  • 基金资助:
    国家自然科学基金(U1813213);四川省科学技术厅项目(2021YJ0129)

Application of vascularized mucosal flap for early-medium-term tongue cancer and floor of mouth cancer defect repair: a preliminary study

Jiang Yueyun1(), Tang Lingling2, Ma Zhongkai1, Liu Wei1, Huang Nengwen1, Li Chunjie1()   

  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.Dept. of Oral and Maxillofacial Surgery, People, s Hospital of Anshun City, Anshun 561000, China
  • Received:2021-09-24 Revised:2022-01-31 Online:2022-04-01 Published:2022-04-01
  • Contact: Li Chunjie E-mail:734302884@qq.com;lichunjie@scu.edu.cn
  • Supported by:
    The National Natural Science Foundation of China(U1813213);Department of Science and Technology Application Fundamental Project of Sichuan Province(2021YJ0129);Correspondence: Li Chunjie, E-mail: lichunjie@scu.edu.cn

摘要: 目的

探究以面动脉为蒂的黏膜肌(FAMM)瓣在修复临床早-中期舌癌及口底癌缺损中的临床效果及安全性。

方法

通过回顾性队列研究的方式纳入使用FAMM瓣(FAMM组)或者皮瓣(皮瓣组)修复早-中期舌癌、口底癌切除后中小型舌、口底缺损的患者,收集患者一般资料及相关手术资料,术后3个月和6个月评估患者满意度、张口度、外形满意度、语音满意度以及进食功能情况。

结果

本研究共纳入患者45名,其中FAMM组15名,皮瓣组30名。所有患者均完成了术后3个月随访,2组各1名患者在术后6个月失访,随访到的患者没有复发及转移征象。FAMM组手术时间短于皮瓣组(P<0.05)。皮瓣组患者术后供瓣区不适多于FAMM组(P<0.05)。2组患者术后总体满意度差异无统计学意义(P>0.05),但FAMM组术后6个月外形满意度、语音满意度和进食功能优于皮瓣组(P<0.05);术后3个月张口度FAMM组小于皮瓣组(P<0.05),但术后6个月2组差异无统计学意义(P>0.05)。

结论

FAMM瓣修复早-中期舌、口底癌切除后中小型的舌、口底缺损具有一定的优势,可以在临床中考虑使用。

关键词: 以面动脉为蒂的黏膜肌瓣, 修复重建外科, 口腔颌面缺损, 舌癌, 口底癌

Abstract: Objective

This study aimed to assess the efficacy and safety of facial artery musculomucosal (FAMM) flap for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer.

Methods

A retrospective cohort study was conducted and included patients with early-medium stage tongue or floor of mouth cancer and reconstructed by FAMM flap or traditional free or axial flaps. Demographic data and surgery-related data were collected. Patients were followed up for 6 months and evaluated with satisfaction, maximal mouth opening, satisfactory contour and speech, and oral intake function at months 3 and 6.

Results

Forty-five patients were included, with 15 in the FAMM group and 30 in the flap group. All patients finished 3 months follow-up, and 1 in each group was lost to follow-up at month 6. All followed-up patients had no recurrence or metastasis. The FAMM group had a significantly shorter surgical time than the flap group (P<0.05). The flap group had significantly more donor sites that were uncomfortable compared with the FAMM group (P<0.05). There was no statistical significance on satisfaction, but the FAMM group had better outcomes on contour, speech, and oral intake function at month 6 than the flap group (P<0.05). The FAMM group had smaller maximal mouth opening than the flap group (P<0.05) at month 3 but equivalent maximal mouth opening at month 6 (P>0.05).

Conclusion

FAMM flap has some advantages for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer, and it could be an ideal choice for clinical application.

Key words: facial artery musculomucosal flap, reconstructive surgery, oral and maxillofacial defects, tongue cancer, floor of mouth cancer

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