PDF(Pubmed)
Abstract：
UNASSIGNED: As oral submucous fibrosis (OSMF) is a chronic progressive disorder, the treatment is based on the severity of the disease. Surgical treatment is the only choice for grade III and grade IV OSMF cases because the patient can neither clean his/her mouth nor properly chew. The resulting soft tissue defect requires resurfacing with various well-vascularized tissues such as extraoral flaps, intraoral flaps, microvascular flaps, and allografts that have been used. Reconstruction of the resultant defects proved to be challenging. Till date, none of the flaps has been proven to be effective and is universally accepted for the treatment of OSMF because of various drawbacks of the available techniques. This study was conducted to know whether an endoscopic-assisted platysma flap is associated with better outcomes in terms of ease of operation and postoperative function than the conventional approach.
UNASSIGNED: This study included 40 patients of grade III and grade IV OSMF reporting to the outpatient department of oral and maxillofacial surgery in a tertiary center of North India. These patients were divided randomly into two groups. Group I and Group II had 20 patients each, undergoing endoscopic-assisted platysma flap and non-endoscopic-assisted platysma flap for reconstruction after resection of OSMF bands, respectively. Data were analyzed for the mouth opening, operating time, flap viability, congestion of neck and oral cavity, signs of inflammation, neurologic assessment, and measurement of the drain.
UNASSIGNED: The results showed significant increase in mouth opening from the preoperative value to the values immediately after surgery and at 24 h, 1 week, 15 days, 1 month, 3 months, and 6 months after surgery in both the study groups. Reduced bleeding incidence was found in group I compared to group II, with better postoperative outcomes noted during follow-up. But the mean intraoperative time of the subjects in group I was 130.80 ± 5.5.908 min and in group II was 105.74 ± 2. 491 min. Increased time taken in group I may be due to the long learning curve.
UNASSIGNED: The present study concluded that the Endoscope-assisted technique has a key role during supra and subplatysmal dissection to allow for better accessibility, handling, and visibility of the flap and its orientation in relation to the underlying structures to avoid postoperative complications and to overcome the drawback of platysma myocutaneous flap in reconstruction of OSMF defects.
UNASSIGNED: This study included 40 patients of grade III and grade IV OSMF reporting to the outpatient department of oral and maxillofacial surgery in a tertiary center of North India. These patients were divided randomly into two groups. Group I and Group II had 20 patients each, undergoing endoscopic-assisted platysma flap and non-endoscopic-assisted platysma flap for reconstruction after resection of OSMF bands, respectively. Data were analyzed for the mouth opening, operating time, flap viability, congestion of neck and oral cavity, signs of inflammation, neurologic assessment, and measurement of the drain.
UNASSIGNED: The results showed significant increase in mouth opening from the preoperative value to the values immediately after surgery and at 24 h, 1 week, 15 days, 1 month, 3 months, and 6 months after surgery in both the study groups. Reduced bleeding incidence was found in group I compared to group II, with better postoperative outcomes noted during follow-up. But the mean intraoperative time of the subjects in group I was 130.80 ± 5.5.908 min and in group II was 105.74 ± 2. 491 min. Increased time taken in group I may be due to the long learning curve.
UNASSIGNED: The present study concluded that the Endoscope-assisted technique has a key role during supra and subplatysmal dissection to allow for better accessibility, handling, and visibility of the flap and its orientation in relation to the underlying structures to avoid postoperative complications and to overcome the drawback of platysma myocutaneous flap in reconstruction of OSMF defects.
摘要：
■由于口腔粘膜下纤维化（OSMF）是一种慢性进行性疾病，治疗是基于疾病的严重程度。手术治疗是III级和IV级OSMF病例的唯一选择，因为患者既不能清洁口腔也不能正确咀嚼。由此产生的软组织缺损需要用各种血管化良好的组织如口外皮瓣进行表面修复，口内皮瓣,微血管皮瓣,和已经使用过的同种异体移植物。重建由此产生的缺陷被证明是具有挑战性的。直到日期,由于现有技术的各种缺点，没有一种皮瓣被证明是有效的，并且被普遍接受用于OSMF的治疗。进行这项研究是为了了解内窥镜辅助颈阔肌皮瓣在操作简便和术后功能方面是否比常规方法具有更好的结果。
■该研究包括40名III级和IV级OSMF患者，他们在北印度三级中心的口腔颌面外科门诊报告。将这些患者随机分为两组。第一组和第二组各有20名患者，接受内镜辅助颈阔肌皮瓣和非内镜辅助颈阔肌皮瓣进行OSMF带切除后重建，分别。分析了开口的数据，操作时间,皮瓣生存力，颈部和口腔充血，炎症的迹象，神经评估，和测量排水。
■结果显示，张口从术前值到术后即刻和24h的值显著增加，1周,15天,1个月,3个月,两组均在手术后6个月进行。与II组相比，I组出血发生率降低，随访期间注意到更好的术后结局。但I组受试者的平均术中时间为130.80±5.5.908分钟，II组为105.74±2。491分钟。第一组时间增加可能是由于学习曲线长。
■本研究得出的结论是，内窥镜辅助技术在上和颈下夹层中具有关键作用，以实现更好的可及性，处理,皮瓣的可见性及其相对于下层结构的方向，以避免术后并发症，并克服颈阔肌肌皮瓣在OSMF缺损重建中的缺点。
■该研究包括40名III级和IV级OSMF患者，他们在北印度三级中心的口腔颌面外科门诊报告。将这些患者随机分为两组。第一组和第二组各有20名患者，接受内镜辅助颈阔肌皮瓣和非内镜辅助颈阔肌皮瓣进行OSMF带切除后重建，分别。分析了开口的数据，操作时间,皮瓣生存力，颈部和口腔充血，炎症的迹象，神经评估，和测量排水。
■结果显示，张口从术前值到术后即刻和24h的值显著增加，1周,15天,1个月,3个月,两组均在手术后6个月进行。与II组相比，I组出血发生率降低，随访期间注意到更好的术后结局。但I组受试者的平均术中时间为130.80±5.5.908分钟，II组为105.74±2。491分钟。第一组时间增加可能是由于学习曲线长。
■本研究得出的结论是，内窥镜辅助技术在上和颈下夹层中具有关键作用，以实现更好的可及性，处理,皮瓣的可见性及其相对于下层结构的方向，以避免术后并发症，并克服颈阔肌肌皮瓣在OSMF缺损重建中的缺点。
