目的

探讨用横向颈阔肌皮瓣（PMF）与颏下动脉岛状肌皮瓣（SAIF）修复口腔癌术后缺损疗效。

方法

选择30 例口腔癌术后缺损患者，其中舌癌18 例、颊癌9 例、腭癌3 例。随机分成PMF 修复组（15 例）和SAIF 修复组（15 例）。观察比较两种肌皮瓣成活率、开口度、面部外形及局部复发情况。追踪观察12 ～18 个月。

结果

30 例患者修复后26 例Ⅰ期愈合，3 例颈阔肌皮瓣术后坏死，成活率为80%；1 例SAIF 术后出现坏死，成活率为93.3%。术后约1 个月皮瓣上皮开始软化，3 个月后上皮角质层大部分脱落，约术后1 年，接近正常黏膜。30 例患者受区功能正常，肿瘤无复发，供区外形良好，开口度正常。2 例患者1 年后因远处转移而死亡。

结论

PMF 与SAIF 均可以用于修复口腔癌术后中小型缺损，SAIF 成活率高于PMF，两者比较有统计学意义（P ＜0.05）。而开口度、面部外形及局部复发情况间差异无统计学意义。

Objective

To investigate the value of transverse platysma myocutaneous fiaps and submental artery island flaps for oral defects repair after cancer surgery.

Methods

Thirty patients with defects after cancer surgery were included， with 18 tongue cancer cases， 9 buccal cancer， 3 cases of palatal tumor.Thirty patients were randomly divided into two groups， 15 cases received lateral platysma skin flap reconstruction， while the other 15 cases received submental artery island myocutaneous flaps.Flap survival rate， mouth opening， aesthetic outcomes and local recurrence of the two methods were observe and compared.Period of followe up for varied from 12 months to 18 months.

Results

Twenty-six out of 30 patients healed smoothly， three cases with platysma flap went necrosis， the survival rate was 80%； necrosis occurred in one case of submental artery island flap after surgery， the survival rate was 93.3%.The flap began to turn soft one month after operation， and most of the epithelia stratum corneum went away after 3 months.About 1 year after surgery， near normal mucosa.Oral function of all 30 patients were acceptable，without local recurrence， the donor appearance were good and mouth opening was normal.Two patients had distant metastases and death after one year.

Conclusions

The transverse platysma flap and submental artery island flap can both be used to repair small to medium defects after cancer surgery， but the submental artery island flap had a higher survival rate than that of the transverse platysma flap （P ＜0.05）.The mouth opening， facial appearance and local recurrence showed no significant difference.