Comparison Of Contralateral Subcondylar Island Flap And Free Forearm Flap In Repairing Postoperative Defect Of Oral Squamous Cell

Objective: The clinical effects of Contralateral vascular pedicle submental island flap and free forearm flaps in repairing postoperative defects of oral squamous cell carcinoma were analyzed and compared,which provided clinicians with different application directions for the flaps.Methods: A total of 87 patients with oral cancer were collected from the Department of Stomatology of the Affiliated Hospital of Guilin Medical College from January 2015 to January 2020.After the lesions were removed,two types of skin flaps were used to repair the postoperative defects of oral cancer.A total of 50 Contralateral vascular pedicle submental island flap(n = 50)and 37 free forearm flaps(n = 37)were compared.The operation time,the number of hospital stays,and postoperative complications of the two flaps were compared.The University of Washington quality of life table was used.The postoperative quality of life was investigated,and oral swallowing function,language function,and postoperative appearance satisfaction were followed up for 1 year.Results: By collecting data and recording,the average time to prepare and repair the Contralateral vascular pedicle submental island flap was 55.98±15.21 min,and the average time to prepare and repair the free forearm flap was 167.54±28.54 min.The operation time of the Contralateral vascular pedicle submental island flap was shorter than that of the free The operation time of forearm flap(P <0.05);the average hospital stay after submental flap was 7.26±2.75 days,and the average hospital stay after free forearm flap was 13.35±5.21 days.Forearm flap(P <0.05).Fifty patients with Contralateral vascular pedicle submental island flap repair had no flap necrosis,no post-oral fistula,no incision infection,etc,and the success rate of flap transplantation was high.One case of free forearm flap caused necrosis of the flap due to vascular crisis.Other flaps were repaired and the postoperative repair effect was good.No complications such as floor fistula and wound infection occurred in all patients.There is no statistically significant difference in the success rate of repair between the Contralateral vascular pedicle submental island flap and the forearm flap(P >0.05).According to the questionnaire of quality of life of the University of Washington,there was no significant difference in the overall quality of life between the two flaps(P> 0.05).All patients were followed up for one year after operation.There was no significant difference in the satisfaction of postoperative swallowing function,language function and appearance between the two groups(P> 0.05).The recurrence rate of the two groups after one year of repair was different.No statistical significance(P> 0.05).Conclusion: The Contralateral vascular pedicle submental island flap and free forearm flap are reliable flaps for repairing postoperative defects of early oral cancer.The Contralateral vascular pedicle submental island flap has high survival rate,simple preparation,no microvascular anastomosis,and postoperative wound concealment.Compared with the free forearm flap,the success rate is high.It is particularly suitable for the repair of the flaps at the basic hospitals with defect microsurgery technology.At the same time,the repair of oral defects with Contralateral vascular pedicle submental island flap can significantly reduce the risk of metastasis and is more reliable than the ipsilateral side.