Case Reports Of Three Kinds Of Skin Flap Transplantation For Reconstruction Of Oral And Maxillofacial Malignant Tumor Surgery Defect

Objective:The degree of invasion of malignant tumor is high,and the possibility of recurrence,recurrence and distant metastasis is high.Therefore,it is always necessary to remove a large amount of normal tissue around the tumor to cut off the malignant tumor cells,so as to reduce the possibility of recurrence,recurrence and distant metastasis.Oral and maxillofacial malignant tumors with large defects,which partial can not draw suture,affect the appearance and function,taking a soft tissue flap to repair the soft tissue defect of the affected area,can reconstruct the oral and maxillofacial appearance at the maximum degree,and improve the quality of life of patients.Methods:In this paper,five patients with oral and maxillofacial malignant tumors were presented between November 2014 to August 2016 in Dalian Stomatology Hospital,who carried out the operation of malignant tumor expansion and soft tissue flap repair in Dalian stomatological hospital.Of which 3 cases of buccal cancer,1 cases of squamous cell carcinoma of the tongue,carcinoma of floor of mouth in 1 cases.The forearm flap surgery to repair the defect in 3 cases,1 cases of supraclavicular artery perforator flap surgery to repair the defect,submental island flap surgery to repair the defect in 1 cases.After admission,the first ask medical history,then preoperative routine examination,and then excision pathology,if diagnosed as squamous cell carcinoma,according to the physical condition of patients and pathological results to determine the size of the affected area,further determined the repair scheme,to risk patients and families account for surgical procedures and operation,after expanded resection of the tumor cutting edge normal tissue is performed frozen section examination,frozen section examination returns no cancer cells,then preparating the flap to repair operation.Postoperative patients were asked to regularly visit,and ask to see the physical condition of patients and the affected area,the recovery of the donor area.Results:5 patients were repaired with soft tissue flap,and the survival rate was 100%,and the recipient and donor sites recovered well.5 patients had good healing of the skin flap and surrounding mucosa.The skin flap is gradual mucosal metaplasia.The results showed that 1 patients with buccal mucosa defects repaired by forearm flap and the 1 patients who received the forearm flap to repair the defect of the floor of the mouth,all of which showed the shape of intraoral repair was good,but the local reaction was not sensitive.The 1 patients with forearm flap to repair the defect of the tongue showed a better shape of the repaired half tongue,but the activity was not as good as that of the contralateral side.The supraclavicular artery perforator flap for reconstruction of buccal mucosa in 1 patients and 1 submental island flap in repairing buccal mucosa and gingiva were reflected good appearance and feel worse than the surrounding normal tissue.The 3 forearm flap in 1 patients reflect donor arm Yin cold pain,1 patients reflect thumb dorsal region numbness,no dysfunction,1 patients reflect the donor arm feels and function completely normal.1 patients with supraclavicular artery perforator flap repair and 1 patients with submental island flap repair were reflected for no obvious discomfort.The 5 patients all had normal function of donor site and were not affected by the operation.Conclusion:Soft tissue flap for repairing oral and maxillofacial malignant tumor operation is risk.However with the development of microsurgery,the success rate of the operation is greatly improved,and the postoperative sequelae are reduced.The flaps were used to restore the anatomic shape of the oral cavity,and to some extent,language,eating and other functions was restored.By the function of the area in addition to its own recovery slowly change,still need to have a good attitude and practice.Although the language can not be completely accurate pronunciation,but still can reach the level of understanding.The main function of mastication is the masticatory function,and the function of the patients with complete jaw can be restored to the preoperative state,and the recovery of the function of the patients with the removal of part of the jaw depends on the time of dental restoration.In addition to the area of the skin scar and some discomfort,the function is not affected.Although there are still some shortcomings in skin flap transplantation,it is necessary to study deeply,but it is still the best way to repair the large defect of oral and maxillofacial malignant tumor.