介绍新的甲状腺上动脉穿支皮瓣(STAPF),并比较胸锁乳突肌皮瓣(SCMMF)的口内应用的临床结果。
在2013年1月至2020年12月之间,回顾性收集了43例口腔癌患者,这些患者接受了肿瘤后重建,并使用了这两种区域皮瓣之一。比较了他们的技术和结果。所有STAPF都是通过放射学评估预先准备的。
尽管常见的动脉起源,STAPF和SCMMF的组成和收获程序不同。尽管SCMMF(n=23)是以旋转样式设计的,大多数STAPFs(n=20)是隔皮穿支皮瓣,有2个嵌合的。此外,STAPFs的大小通常大于SCMMF(p=0.006).STAPF的成功率要高得多,只有三个局部皮肤坏死。放疗延迟在用SCMMF重建的患者中更常见(P=0.046),主要是由于瘘管形成。此外,SCMMF组9例(20.9%)患者也有不完全IIB水平夹层报告.在我们的研究中,总生存率受皮瓣条件(p=0.014,1.333-12.881)和术后手术并发症(瘘除外)(P=0.005,2.240-84.134)的影响.从功能上讲,STAPF组的重建后言语和颈部活动能力更好(p<0.001)。
通过在颈部使用局部皮瓣的积累经验,STAPF,当充分准备时,可以为各种口内缺损提供优越的重建结果。作为与同一中间区域中的SCMMF的比较,STAPF是口腔癌患者具有更高的成功率和肿瘤安全性的可行选择。
To introduce new superior thyroid artery perforator flaps (STAPF), and to compare the clinical outcomes with sternocleidomastoid myocutaneous flaps (SCMMF) for their intraoral applications.
Between January 2013 and December 2020, forty-three oral cancer patients who received post-oncologic reconstructions with one of these two regional flaps were retrospectively collected. Their techniques and outcomes were compared. All the STAPFs were preprepared with radiologic evaluations.
Despite the common arterial origins, the compositions and harvesting procedures of STAPF and SCMMF were different. Though SCMMFs (n = 23) were designed in rotational styles, most STAPFs (n = 20) were septocutaneous perforator flaps, with 2 chimeric ones. In addition, the sizes of STAPFs were generally larger than those of SCMMFs (p = 0.006). Success rate for STAPFs was much higher, with only three partial cutaneous necroses. Radiotherapy delay was more frequently found in those reconstructed with SCMMFs (P = 0.046), mostly due to fistula formations. Besides, incomplete level IIB dissections were also reported in 9 (20.9%) patients in SCMMF group. In our
study, the overall survival was affected by both flap conditions (p = 0.014, 1.333-12.881) and postoperative surgical complications (except fistula) (P = 0.005, 2.240-84.134). Functionally speaking, post-reconstructive speech and neck mobility (p < 0.001) were better in the STAPF group.
With accumulated experiences on the use of locoregional flaps in the neck, STAPF, when well-prepared, can provide superior reconstructive outcomes for various intraoral defects. As a comparison with SCMMF in the same middle region, STAPF is a viable option with higher success rates and oncological safety for oral cancer patients.