Objective To report 4 methods of reconstructing soft tissue defects in oral and maxillofacial regions after tumors resection using cervical pedicle tissue flaps. Methods One hundred seventy-two soft tissue defects were repaired with cervical myocutaneous flaps after resection of oral and facial cancer( 165 cases of squamous cell carcinoma and 7 cases of salivary carcinoma). The clinical stage of the tumors was stage Ⅰ in 21 cases, stage Ⅱ in 116 cases and stage Ⅲin 35 cases. Primary sites of the lesions were the tongue (59 cases), buccal mucosa (55 cases), lower gingiva (26 cases), floor of the mouth (25 cases), parotid gland (4 cases) and oropharynx (3 cases). Infrahyoid myocutaneous flaps were used in 60 cases, platysma flaps in 45 cases, sternocleidomastoid flaps in 59 cases and submental island flaps in 8 cases. The sizes of skin paddle ranged from 2.5 cm×5.0 cm to 5.0 cm ×8.0 cm. Results Among 153 survival flaps, there were55 infrahyoid myocutaneous flaps, 40 platysma flaps, 52 sternocleidomastoid flaps and 6 submental island flaps. There were 11 cases of total flap necrosis and8 cases of partial flap necrosis. The success rates were 91.67%(55/60) for infrahyoid myocutaneous flap, 88.89%(40/45) for platysma flap, 88.14% (52/59) for sternocleidomastoid flap and 75%(6/8) for submental island flap. After a follow-up of 3 11 years(5.7 years on average) among 101 cases local reccurence in 18 cases, cervical reccurence in 4 cases, distance metastasis in 2 cases. The survical rate at 3 years were 83.17%(84/101). Conclusion Cervical pedicle tissue flaps haveclinical value in reconstruction of small and medium-sized soft tissue defects after resection of oral and maxillofacial tumors.
ObjectiveTo investigate the effectiveness of bipaddled anterolateral thigh perforator flap in repair of through-and-through maxillofacial defect following oral cancer ablation.MethodsBetween January 2008 and December 2016, 42 patients with oral cancer were treated. There were 31 males and 11 females with an average age of 44.5 years (range, 31-68 years). There were 28 cases of buccal mucosa carcinoma, 10 cases of basal cell carcinoma of buccal skin, 3 cases of gingiva carcinoma, and 1 case of recurrent parotidduct carcinoma. The disease duration ranged from 1 to 24 months (mean, 13.5 months). The size of through-and-through maxillofacial defect ranged from 6.0 cm×4.5 cm to 9.0 cm×7.0 cm. All defects were repaired with the bipaddled anterolateral thigh perforator flap. The paddles were adjusted to repair the buccal area. And the size of flap ranged from 7 cm×5 cm to 10 cm×8 cm. The donor sites were closed directly.ResultsThe operation time was 4.5-7.5 hours (mean, 5.5 hours). All flaps healed and the wounds of recipient and donor sites healed by first intention. All patients were followed up 9-60 months (mean, 22 months). All patients were satisfied with their facial appearance and the speech function. The range of mouth opening was 3-5 cm. Three patients died of recurrence during the follow-up period and the other patients were alive.ConclusionThe bipaddled anterolateral thigh perforator flap is flexible and reliable for the through-and-through maxillofacial defect reconstruction following oral cancer ablation.