G. Mittal, Himanshu Bhutani, A. Gautam, M. Agarwal
{"title":"Clinical outcome and oncological safety of submental flap for reconstruction in head and neck cancer patients","authors":"G. Mittal, Himanshu Bhutani, A. Gautam, M. Agarwal","doi":"10.18231/J.JOOO.2020.029","DOIUrl":null,"url":null,"abstract":"Background: Submental flap is an axial pattern, myo-cutaneous flap based on submental artery (branch of facial artery). We have used this novel flap for reconstruction of the intra-oral, as well of the lower and mid face defects created after resection of certain intra-oral malignancies. Materials and Methods: This study included 15 patients and done over a period of 3 years. Cases were operated by a team of surgical oncologists using the same technique and under 2.5 x magnifications (loupe). Any nodes in the region were carefully dissected and sent for frozen section for intra-operative verification of presence or absence of microscopic tumor deposits. Evaluation had been done based on the clinical and pathological staging, nodal status as well as the patient outcome. Results: Out of the 15 patients who underwent reconstruction with submental flap, one patient developed total flap loss, whereas one patient had partial flap necrosis. The remaining 13 patients showed decent clinical outcome and the flap uptake was good. In the follow up period of 2 years, two patients developed regional recurrence (none in the flap donor or recipient sites) and 2 developed distant metastasis. Conclusion: Submental flap is an excellent flap for reconstruction of small to medium size defects for intra-oral as well as lower and mid face. It is useful in medically compromised conditions, old age or low socio-economic status of the patient as these factors preclude the use of a free flap. It is oncologically safe for reconstruction and in the absence of clinical or radiological evidence of nodal disease in sub-mental region and may be considered for reconstruction in N0 as well as N1 patients. © 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/4.0/)","PeriodicalId":16606,"journal":{"name":"Journal of oral medicine","volume":"50 1","pages":"132-136"},"PeriodicalIF":0.0000,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of oral medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18231/J.JOOO.2020.029","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
颏下皮瓣重建头颈部肿瘤的临床疗效及肿瘤安全性
背景:颏下皮瓣是一种以颏下动脉(面动脉分支)为基底的轴型肌皮皮瓣。我们使用这种新颖的皮瓣重建口腔内,以及在某些口腔内恶性肿瘤切除后产生的面部下部和中部缺陷。材料和方法:本研究纳入15例患者,历时3年。病例由一组外科肿瘤学家使用相同的技术在2.5倍放大镜下进行手术。仔细解剖该区域的任何淋巴结并进行冷冻切片,以术中验证显微镜下肿瘤沉积物的存在或不存在。根据临床和病理分期、淋巴结状态以及患者预后进行评估。结果:在15例行颏下皮瓣重建的患者中,1例发生皮瓣全损,1例发生皮瓣部分坏死。其余13例临床结果良好,皮瓣摄取良好。随访2年,2例发生局部复发(供、受体均无),2例发生远处转移。结论:颏下皮瓣是修复口腔内及面部下、中、小尺寸缺损的理想皮瓣。它是有用的在医学上有缺陷的条件,老年或低社会经济地位的病人,因为这些因素排除了使用游离皮瓣。在没有临床或放射学证据证明精神亚区淋巴结疾病的情况下,它在肿瘤学上是安全的,可以考虑在N0和N1患者中进行重建。©2020由创新出版社出版。这是一篇基于CC BY-NC许可的开放获取文章(https://creativecommons.org/licenses/by-nc/4.0/)
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