简介:肿瘤切除后的口腔重建计划是头颈部外科医生的关键点。必须考虑两个方面:手术缺损的大小和作为解剖区域的口腔的复杂性。Weofferareviewoftheliteraturethatfocusedonfourtypesoflocoregionalflapthatcanbeprofitablyusedforsuchrebuilding:influid(IF),鼻唇(NF),桔梗(PF),和从属(SF)。方法:根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行研究。本系统综述是根据PICOS的缩写,通过在PubMed/MEDLINE上的全面电子搜索进行的,科克伦图书馆,和谷歌学者数据库。对于每个选定的文章,我们推断了八个主要参数,通过方差分析检验比较所有平均值。口腔缺损的尺寸被称为“小”(<7cm2),“中”(7-50cm2),或“大”(>50cm2)。结果:共入选139篇文献,共5898例患者。每种皮瓣的平均年龄均无统计学意义(p=0.30,p>0.05)。报告了七个亚位置的口腔缺陷:最常见的是舌头(2003年[34.0%]患者),其次是嘴巴的地板(1786[30.4%]),颊粘膜(981[16.6%]),脸颊(422[7.2%]),硬腭(302[5.1%]),牙槽嵴(217[3.7%]),和后磨牙三角(187[3.2%])。缺损以中型为主(4507例[76.4%]患者),较少的是小型(1056[17.9%])或大型(335[5.7%])。注意到并发症,其中最常见的是皮瓣坏死,在0.57%的病例中可见。功能和美学结果主要是积极的。结论:当排除其他选择时,局部区域皮瓣代表了中型缺损的良好替代品,以及小型和大型缺损的相当好的替代品。
Introduction: The planning of oral reconstruction after tumor resection is a pivotal point for head and neck surgeons. It is mandatory to consider two aspects: the size of the surgical defect and the complexity of the oral cavity as an anatomical region. We offer a review of the literature that focuses on four types of locoregional flaps that can be profitably used for such reconstruction: infrahyoid (IF), nasolabial (NF), platysma (PF), and submental (SF). Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review was carried out according to the PICOS acronym through a comprehensive electronic search on PubMed/MEDLINE, Cochrane Library, and Google Scholar databases. For each selected article, we extrapolated eight main parameters, of which all mean values were compared through an ANOVA test. The dimensions of the oral defects were referred to as \"small\" (<7 cm2), \"medium\" (7-50 cm2), or \"large\" (>50 cm2). Results: A total of 139 articles were selected with a total of 5898 patients. The mean ages for each type of flap were not statistically significant (p = 0.30, p > 0.05). Seven sublocations of oral defects were reported: The most common was the tongue (2003 [34.0%] patients), followed by the floor of the mouth (1786 [30.4%]), buccal mucosa (981 [16.6%]), cheek (422 [7.2%]), hard palate (302 [5.1%]), alveolar ridge (217 [3.7%]), and retromolar trigone (187 [3.2%]). The defects were mainly medium-sized (4507 [76.4%] patients), and fewer were small-sized (1056 [17.9%]) or large-sized (335 [5.7%]). Complications were noted, the most frequent of which was flap necrosis, seen in 0.57% of cases. The functional and esthetical results were mainly positive. Conclusions: Locoregional flaps represent a good alternative in medium-sized defects as well as a fairly good alternative in small- and large-sized defects when other options are ruled out.