Clinical Observation Of Two Different Methods To Repair The Defects Of Buccal Mucosa

Background Different type of lesions can occur in oral maxillofacial soft tissue, buccal mucosa are the common occurrence, drug and surgical resection can treatment of this lesions. Not only affects the appearance, also caused the limitation of mouth opening, and speech and chewing dysfunction. Reconstructive options for mucosal defects of the oral clinical have included primary closure, mucosal transfer, split-thickness skin grafts(STSGs), and free microvascular transfer of tissues[1]. In the previous decade, the acellular dermal matrix(ADM) has been found to have wide applications in many areas of reconstructive surgery and achieved the desired effect of surgery[2]. ADM is a homogeneous or heterogeneous dermal tissue after the removal of its cellular components.The homogeneous ADM from death row, due to the ethical aspects, it were increasingly to use; heterogeneous ADM mainly using on current clinical, it prepared from the mammals skin(such as cattle, pigs, etc.), it was an ideal safe and effective leather alternative or repair defects.Purpose To observe and compare the clinical effect of PBFPF and ADM in repairing the defect of buccal mucosa.Methods This study choose December 2012- December 2013 in 46 cases of buccal soft tissue defect patients, including 25 males and 21 females. All cases including papilloma 7 cases, vascular malformations 14 cases, lipoma 4 cases, pleomorphic adenoma 9 cases, leukoplakia 2 cases, fibrosis 2 cases, traumatic ulcer submucosal 1 case, not infiltrating squamous cancer 3 cases(T1N0M0 1 cases, T2N0M0 stage 2 cases, UICC 2010 edition), low-grade not infiltrating mucoepidermoid carcinoma 4 cases (T1N0M0 stage, UICC 2010 edition). The defect area were 2.3 cm × 3.7 cm ~ 4.2 cm × 5.1 cm,all cases can not be sutured directly. Forty-six patients were randomly divided into two groups(PBFPF and ADM). Observe, record and statistical analysis the preoperative and postoperative 1 to 6 months MMO, repaired time, patient’s satisfaction of two groups.Result All of two groups were survived, no significant hematoma, infection, local necrosis, excessive scarring and facial nerve damage and so on. The MMO was statistically less in the group ADM and 1~3 days after surgery(P< 0.05). 1~6 months after surgery, statistically significant difference was not found in MMO between the two groups. The repaired time between two groups was statistically significant difference, PBFPF groups’ more than ADM(P<0.05).And there was no statistically significant difference in two groups of degree of satisfaction.Conclusion Both methods can meet the requirements of the case which treatment of benign and malignant tumors(T2N0M0) in the oral buccal soft tissue, ADM is more flexible using than PBFPF. But by limiting the number of cases, whether the first time to repair malignant tumors(T2N0M0 or T1N0M0) is appropriate, needs further study.