Clinical Application Of Submental Island Flap In Repairing Postoperative Defects Of Malignant Oral-maxillofacial Tumors

Objective:To explore the clinical application of submental island flap for reconstruction of postoperative defect of malignant oral and maxillofacial tumors and summarize the clinical experience.Methods:From January 2012 to January 2016,46 cases of oral and maxillofacial soft tissue defects repaired by submental island flaps in department of Stomatology of the first hospital of Shanxi Medical University was collected.According to the pathological type of tumor,it was divided into squamous cell carcinoma group and salivary gland origin malignant tumor group.Patients in the squamous cell carcinoma group were divided into four groups according to tumor location,TNM stage,pathological differentiation and presence or absence of cervical lymphatic metastasis,and the recurrence rate of tumors in each group was statistically analyzed.Results:1.Among the 31 cases of submental island flap to repair the defects of oral and maxillofacial squamous cell carcinoma,16 cases recurred and the recurrence rate was 48.2%.11 cases of submental island flap were used to repair the salivary glands and the patients with malignant tumor,2 cases relapsed and the recurrence rate was 18.2%.The recurrence rate of the squamous cell carcinoma group was higher than that of the salivary gland.(P < 0.05)2.The recurrence rate of oral squamous cell carcinoma patients was higher than that of oral and pharyngeal squamous cell carcinoma patients(P < 0.05)in 31 cases with submental island flap for repairing the postoperative defect of oral and maxillofacial squamous cell carcinoma.The recurrence rate of stage I and II patients was lower than that of stage III and IV patients(P < 0.05).The recurrence rate of tumors in the high differentiation group was lower than that in the medium and poorly differentiated group(P < 0.05).The tumor recurrence rate of patients with positive cervical lymph nodes was higher than that of patients with negative cervical nodes(P < 0.05).3.In 18 cases of submental island flap for the repair of oral and maxillofacial malignant tumor,there were 10 cases of tumor recurrence in situ,4 cases with cervical lymph node metastasis in situ,3 cases with simple cervical lymph node metastasis and 1 cases of distant metastasis.Conclusion:1.The submental island flap can be used to repair the soft tissue defect after the early stage of highly differentiated oropharyngeal squamous cell carcinoma and early malignant tumor of salivary gland.2.It is not recommended to use submental island flap to repair the tissue defect of squamous cell carcinoma with poor differentiation and high risk of lymphatic metastasis in tongue,floor of mouth and cheek.