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

doi:10.19438/j.cjoms.2020.05.010

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (5): 434-437.doi: 10.19438/j.cjoms.2020.05.010

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

王友元, 刘志新, 朱川东, 周斌, 袁开放, 汪延, 杨朝晖, 陈伟良

中山大学孙逸仙纪念医院口腔颌面外科,广东广州 510120

收稿日期:2019-09-23 修回日期:2020-03-13 出版日期:2020-09-20 发布日期:2020-10-28
通讯作者: 陈伟良,E-mail:drchen@vip.163.com
作者简介:王友元（1981-）,男,博士,副主任医师,E-mail：wangyy78@mail.sysu.edu.cn

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

WANG You-yuan, LIU Zhi-xin, ZHU Chuan-dong, ZHOU Bin, YUAN Kai-fang, YAN Wang, YANG Zhao-hui, CHEN Wei-liang

Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Guangzhou 510120, Guangdong Province, China

Received:2019-09-23 Revised:2020-03-13 Online:2020-09-20 Published:2020-10-28

摘要/Abstract

摘要： 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。

关键词: 腭癌, 上颌骨缺损, 颏下动脉岛状瓣, 老年患者

Abstract: 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.

Key words: Palatal cancer, Maxillary defects, Submental flap, Older patients

中图分类号:

R782.2

王友元, 刘志新, 朱川东, 周斌, 袁开放, 汪延, 杨朝晖, 陈伟良. 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[J]. 中国口腔颌面外科杂志, 2020, 18(5): 434-437.

WANG You-yuan, LIU Zhi-xin, ZHU Chuan-dong, ZHOU Bin, YUAN Kai-fang, YAN Wang, YANG Zhao-hui, CHEN Wei-liang. Clinical outcomes of 65 patients with palatal cancer ablation following facial-submental artery island flap reconstruction of Brown class II maxillary defects[J]. China J Oral Maxillofac Surg, 2020, 18(5): 434-437.

参考文献

[1] Dos Santos Costa SF, Brennan PA, Gomez RS, et al. Molecular basis of oral squamous cell carcinoma in young patients: Is it any different from older patients?[J]. J Oral Pathol Med, 2018, 47(6): 541-546.
[2] Hilly O, Shkedy Y, Hod R, et al.Carcinoma of the oral tongue in patients younger than 30 years: Comparison with patients older than 60 years[J]. Oral Oncol, 2013, 49(10): 987-990.
[3] Hamelinck VC, Bastiaannet E, Pieterse AH, et al.Preferred and perceived participation of younger and older patients in decision making about treatment for early breast cancer: A prospective study[J]. Clin Breast Cancer, 2018, 18(2): e245-e253.
[4] Brown JS, Shaw RJ.Reconstruction of the maxilla and midface: Introducing a new classification[J]. Lancet Oncol, 2010, 11(10): 1001-1008.
[5] 于森, 王洋, 毛驰, 等. 1107例上颌骨缺损的临床分类及修复方法分析[J]. 北京大学学报(医学版), 2015, 47(3): 509-513.
[6] Chen WL, Li JS, Yang ZH, et al.Two submental island flaps for reconstructing oral and maxillofacial defects following cancer ablation[J]. J Oral Maxillofac Surg, 2008, 66(6): 1145-1156.
[7] WHO website. Proposed working definition of an older person in Africa for the MDS Project [DB/OL]. http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html.
[8] Edge SB, Byrd DR, Compton CC.AJCC cancer staging manual[M]. 7th Ed. New York: Springer-Verlag, 2010.
[9] WHO website. International statistical classification of diseases and related health problems [DB/OL]. 10th revision, 2010. http://apps.who.int/ classifications/icd10/browse/2010/en.
[10] Ragbir M, Brown JS, Mehanna H.Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines[J]. J Laryngol Otol, 2016, 130(S2): S191-S197.
[11] Hamelinck VC, Bastiaannet E, Pieterse AH, et al.Preferred and perceived participation of younger and older patients in decision making about treatment for early breast cancer: A prospective study[J]. Clin Breast Cancer, 2018, 18(2): e245-e253.
[12] Cordeiro PG, Santamaria E.A classification system and algorithm for reconstruction of maxillectomy and midfacial defects[J]. Plast Reconstr Surg, 2000, 105(7): 2331-2346.
[13] Schonauer F, Di Martino A, Nele G, et al.Submental flap as an alternative to microsurgical flap in intraoral post-oncological reconstruction in the elderly[J]. Int J Surg, 2016, 33(Suppl 1): S51-56.
[14] Chen WL, Ye JT, Yang ZH, et al.Reverse facial artery-submental artery mandibular osteomuscular flap for the reconstruction of maxillary defects following the removal of benign tumors[J]. Head Neck, 2009, 31(6): 725-731.
[15] Chen WL, Zhou M, Ye JT, et al.Maxillary functional reconstruction using a reverse facial artery-submental artery mandibular osteomuscular flap with dental implants[J]. J Oral Maxillofac Surg, 2011, 69(11): 2909-2914.
[17] Yetzer J, Fernandes R.Reconstruction of orbitomaxillary defects[J]. J Oral Maxillofac Surg, 2013, 71(2): 398-409.
[18] Chen WL, Yang ZH, Huang ZQ, et al.Craniofacial resection and reconstruction in patients with recurrent cancer involving the craniomaxillofacial region[J]. J Oral Maxillofac Surg, 2017, 75(3): 622-631.

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

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

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 5

编辑推荐

Metrics

本文评价

[1]	赵鹏程, 刘锦星, 纪均. 盐酸戊乙奎醚对接受口腔颌面部手术的老年患者认知功能的影响[J]. 中国口腔颌面外科杂志, 2019, 17(3): 261-264.
[2]	刘秉尧, 曹罡, 董震, 陈伟, 徐金科, 张森林. 3-D打印技术用于钛网修复全上颌骨缺损6例报道[J]. 中国口腔颌面外科杂志, 2016, 14(6): 562-566.
[3]	张燕, 殷琦, 李燕, 倪莹, 孙璐璐, 郭勇. 集束化护理和常规护理对老年口腔癌患者术后谵妄的影响[J]. 中国口腔颌面外科杂志, 2016, 14(2): 162-166.
[4]	于淼, 秦兴军, 徐立群. 血管化复合组织瓣修复全上颌骨缺损的临床进展[J]. 中国口腔颌面外科杂志, 2015, 13(3): 273-279.
[5]	赵新, 伍虹, 陈伟良, 王建广, 张翠翠, 潘朝斌, 黄志权, 赵小朋. 去上皮逆行面动脉-颏下动脉颏下岛状瓣修复上颌术后缺损[J]. 中国口腔颌面外科杂志, 2014, 12(1): 61-64.