| Objective:Sternocleidomastoid flap is a pedicled flap which is supplied mainly by the thyroid artery.Although the anatomy of this flap had been relatively researched,the differences between patients’ anatomy of arteries and veins were big.when preparing the sternocleidomastoid flap,it’s main supply arteries were easy to harm.So,using this flap to repair defects has some risks.In order to provide helps for clinical use,we compare the outcomes of using multiple kinds of sternocleidomastoid flap or common clinical flaps to repair defects after oral cancer surgery.Methods:From September 2015 to March 2018,73 patients with oral cancer were underwent operations by the same team from the affiliated Hospital of Qingdao University.Among them,67 cases were diagnosed as squamous cell carcinoma,4 cases as adenoid cystic carcinoma and 2 cases as osteosarcoma.Twenty-eight cases using sternocleidomastoid flaps,30 cases using free flaps,and 15 cases using submental island flap were included in this study.According to the repair method,all cases were divided into 3 groups,and the evaluation indexes of each group were recorded.The Patients’ basic informations included age,size and location of tumor,TNM stage and information of patients with systemic diseases.Surgical informations included size of flap,time and cost of operation,length of stay,tracheotomy rate,and the vitality of flap.The postoperative functional informations included diet after surgery,mouth opening degree and the recurrence and Metastasis of carcinoma.All statistical analysis was performed using the SPSS 22.0 software package.The basic and surgical informations were analyzed between Sternocleidomastoid flap group and free flap group,as well as sternocleidomastoid flap group and submental island flap group.The postoperative function informations were analyzed between three groups.Data are expressed as mean ± standard deviation(SD)or n(%).Differences between groups were compared using a two tailed Student’s t test(quantitative data)or χ2 test(qualitative data).For those datas which did not meet the χ2 test’s match condition,were used the Mann-Whitney U test.Values of <0.05 were considered statistically significant.Results:Compared with free flaps,tumor size mostly belonged to(T1-T2),and the primary sites were the tongue,gingiva,floor of the mouth,buccal mucosa in patients undergoing sternocleidomastoid flaps,whose average age was higher,surgical time was shorter,systemic diseases was more serious,and surgical cost,hospital stay,tracheotomy rate was less than patients undergoing free flaps(P<0.05).Compared with sternocleidomastoid flaps,the primary sites were base of tongue or oropharynx,flap size was large,hospital stay and tracheotomy rate was higher than patients undergoing Submental island flaps(P < 0.05).Patients in the three groups had similar oral function after surgery(P>0.05).Conclusion:Selection of sternocleidomastoid flaps,free flaps or submental island flaps for repairing oral cancer defects is dependent on a variety of factors such as the age of patients,the sizeand location of tumor,metastasis of neck lymph nodes and the general conditions.Sternocleidomastoid flap is a good choice for patients with advanced ages,small size of lesions(T1-T2)and concomitant systemic diseases,while do not use for Patients with a history of radiotherapy or metastatic lymph nodes in the Ⅱ-Ⅳ region of neck.Submental island flap can be selected for patients whose locations are in oropharynx,average age is high,the size of lesion is small,or have concomitant systemic diseases.Meanwhile,The metastatic lymph nodes should not be finded in I region of neck. |
PDF Full Text Request