Clinical Study On The Preparation Of Submental Artery Perforator Flap Based On Different Anatomical Relationship Between Submental Artery And Submandibular Gland

Objective: Analyze the anatomical relationship between the two common types of submental arteries and the submandibular gland in clinical practice,explore the differences in the process of submental artery perforator flap harvest corresponding to different anatomical relationships,compare and clarify whether there are differences in surgical and postoperative outcomes between the two harvesting processes.Method: This is a retrospective study,involving 30 patients who underwent resection of oral and maxillofacial malignant tumors by the same surgeon in the Department of Oral and Maxillofacial Head and Neck Surgery of the Affiliated Stomatological Hospital of China Medical University from January 1,2019 to November 30,2020.At the same time,the submental artery perforator flap was used to repair soft tissue defects and neck lymph node dissection.The patients were divided into groups according to the two anatomical positions of the submental artery and submandibular gland recorded during the operation.The differences between the two groups were compared in the operation time,flap area,perioperative complications of the flap and the donor and recipient area,postoperative hospital stay and the recurrence rate of tumor.To explore whether the two extraction processes lead to differences in surgical and prognostic results under the different anatomical positions of the submental artery and submandibular gland.Results: The operation of 30 cases was successful,and the survival rate of the flap was 100%.There were no obvious complications in the donor and recipient areas.The flap complications included 6 cases of self-relieving venous reflux obstruction that occurred in the perioperative period.The relationship between the submental artery and the submandibular gland observed and recorded during the operation can be divided into two types: one is that the submental artery runs between the superficial lobe of the submandibular gland and the mandibular hyoid muscle(group1),a total of 19 cases(63.3%);Another is the submental artery,which runs between the upper edge of the submandibular gland and the mandibular body(group 2),a total of 11 cases,accounting for 36.7%.There was no statistically significant difference between the two groups in the results of operation time,flap area,perioperative complications of flap and donor/recipient area,and postoperative hospital stay(P>0.05).The average follow-up time of the two groups was 16.05 ± 4.70 months and14.45 ± 6.12 months respectively(P>0.05).During the follow-up period,there was no cervical recurrence and metastasis in both groups.The recurrence rates of the two groups were 15.8%(3/19)and 27.3%(3/11)respectively(P>0.05).Conclusions: This study suggests that the two different anatomical positions of the submental artery and submandibular gland correspond to different preparation processes.The both preparation processes are safe and effective,and there is no significant difference in surgical results and prognosis.