Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (8): 500-504.doi: 10.12016/j.issn.2096-1456.2019.08.005

• Cinical Study • Previous Articles     Next Articles

Application of extended clavicular epithelial flap in postoperative defect repair in elderly patients with oral cancer

LIN Shigeng1,WANG Tao1,WANG Hong1,SUN Yin1,FAN Song2()   

  1. 1. Department of Oral and Maxillofacial Surgery, Hainan Provincial People′s Hospital·The Affililated Hainan Hospital of Hainan medical university, Haikou 570100, China;
    2. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
  • Received:2019-01-23 Revised:2019-03-20 Online:2019-08-20 Published:2019-08-16
  • Contact: Song FAN E-mail:fansong8888@163.com

Abstract:

Objective To explore the clinical application of an extended clavicular epithelial flap with a transverse cervical arterial blood supply in the repair of postoperative soft tissue defects in elderly patients with oral cancer.Methods From January 2015 to June 2018, 24 elderly patients with oral cancer were admitted to the Department of Oral and Maxillofacial Surgery, Hainan Provincial People′s Hospital, including 15 males and 9 females, aged 65-82 years, with an average age of 71.8 years. The supraclavicular epithelial flap was used to repair the soft tissue defect after radical resection of the oral cancer. The flap was at least 4 cm × 6 cm, and the maximum size was 7 cm × 9 cm. All patients completed a University of Washington Quality of Life (UW-QOL) survey 6 months after surgery, and a subjective satisfaction survey was conducted.Results The prolonged clavicular epithelial flap survival rate was 91.6% (22/24). The patients had good speech and swallowing function, hidden scars and no obvious sequelae. The average UW-QOL score 6 months after the operation was 76.5 ± 6.4. The follow-up satisfaction rate was 87.5% (21/24).Conclusion An extended clavicular epithelial flap with a transverse cervical arterial supply is reliable, of moderate thickness, is simple to implement, causes little trauma at the donor site, and yields a relatively concealed donor site. It is suitable for the simultaneous repair of soft tissue defects in elderly patients with oral cancer.

Key words: oral cancer, elderly patient, supraclavicular flap, defect reparation, fasciocutaneous flap, transverse cervical arterial, axial flap

CLC Number: 

  • R739.8

Table 1

Clinical data of 24 elderly patients with oral cancer"

序号 年龄(岁)/ 部位/病理类 颈淋巴 皮岛大小 皮岛并 手术时间(h)/ 麻醉 系统性疾病 术后全身
性别 型/临床分期 清扫术 (cm) 发症 出血量(ml) 分级 并发症
1 68/M 舌/SCC/T3N1M0 BND 6 × 8 6.5/500 ASAⅠ
2 66/F 颊/SCC/T2N0M0 IND 6 × 6 4.5/400 ASAⅡ 高血压
3 68/F 下牙龈/SCC/T3N0M0 IND 6 × 8 6/450 ASAⅠ
4 69/M 舌/SCC/T4N1M0 BND 7 × 9 6.5/500 ASAⅡ 冠心病 肺炎
5 77/F 颊/SCC/T3N0M0 IND 6 × 8 4.5/400 ASAⅠ
6 70/M 舌/SCC/T2N0M0 IND 4 × 6 皮岛坏死 4.5/400 ASAⅠ
7 66/M 下牙龈/SCC/T3N1M0 IND 5 × 7 5/400 ASAⅠ
8 82/F 舌/SCC/T2N0M0 IND 4 × 6 4.5/300 ASAⅡ 冠心病,高血压
9 65/M 舌/SCC/T3NIM0 IND 6 × 8 4.5/450 ASAⅠ
10 72/M 腭/SCC/T3N0M0 IND 6 × 8 远端坏死 4.5/400 ASAⅠ 痛风 肺炎
11 75/F 下牙龈/SCC/T2N0M0 IND 5 × 7 皮岛坏死 5/500 ASAⅠ 糖尿病
12 66/M 口底/ACC/T2N0M0 IND 4 × 5 4.5/400 ASAⅡ 高血压
13 68/M 舌/SCC/T4N0M0 BND 6 × 8 6.5/500 ASAⅡ 冠心病,高血压
14 75/M 口底/SCC/T3N0M0 BND 6 × 7 6/450 ASAⅡ 糖尿病
15 70/F 颊/SCC/T3N0M0 IND 5 × 7 5/400 ASAⅠ 痛风
16 69/F 上牙龈/SCC/T3N0M0 IND 6 × 8 远端坏死 5/500 ASAⅡ 高血压,糖尿病
17 76/M 舌/SCC/T2N0M0 IND 4 × 5 5/400 ASAⅠ
18 80/M 舌/SCC/T3N0M0 IND 5 × 7 5/400 ASAⅢ 冠心病,高血压 心衰
19 70/M 颊/SCC/T2N0M0 IND 5 × 6 4.5/300 ASAⅠ
20 68/F 上牙龈/SCC/T3N0M0 IND 6 × 7 4.5/400 ASAⅠ
21 81/M 腭/ACC/T2N0M0 IND 5 × 6 4/400 ASAⅡ 痛风 肺炎
22 72/F 舌/SCC/T3N0M0 IND 5 × 6 远端坏死 4.5/400 ASAⅠ 糖尿病
23 79/M 下牙龈/SCC/T2N0M0 IND 5 × 6 4.5/400 ASAⅡ 冠心病
24 72/M 舌/SCC/T3NIM0 IND 6 × 7 5/400 ASAⅡ 冠心病 肺炎

Figure 1

Harvest of extended supraclavicular flap"

Figure 2

Clinical situation of lower-right jaw cancer patient 12 months after repair"

[1] Fan S, Zhang HQ, Li QX , et al. The use of a honeycomb technique combined with ultrasonic aspirators and indocyanine green fluorescence angiography for a suoerthin anterolateral thigh flap: a pilot study[J]. Plast Reconstr Surg, 2018,141(6):902e-910e.
[2] Segna E, Bolzoni AR, Gianni AB , et al. Impact of reconstructive microsurgery on patients with cancer of the head and neck:a prospective study of quality of life, particularly in older patients[J]. Br J Oral Maxillofac Surg, 2018,56(9):830-834.
[3] Chen WL, Zhang DM, Yang ZH , et al. Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation[J]. J Oral Maxillofac Surg, 2010,68(10):2422-2430.
[4] Faisal M, Adeel M, Riaz S , et al. The submental island flap in head and neck cancer[J]. Ann Maxillofac Surg, 2018,8(2):287-291.
[5] Tripathi M, Parshad S, Karwasra RK , et al. Pectoralis major myocutaneous flap in head and neck reconstruction: an experience in 100 consecutive cases[J]. Natl J Maxillofac Surg, 2015,6(1):37-41.
[6] Ren ZH, Wu HJ, Wang K , et al. Anterolateral thigh myocutaneous flaps as the preferred flaps for reconstruction of oral and maxillofacial defects[J]. J Craniomaxillofac Surg, 2014,42(8):1583-1589.
[7] Padiyar BV, Azeem Mohiyuddin SM ,Saqayarai , et al.Usefulness of supraclavicular flap in reconstruction following resection if oral cancer[J]. 2017,4(2):148-152.
[8] Pallua N, Machens HG, Rennekampff O , et al. The fasciocutaneous supraclavicular artery island flap for releasing postburn mentosternal contractures[J]. Plast Reconstr Surg 1997,99(7):1878-1884.
[9] Lee S, Cho HM, Kim JK , et al. The supraclavicular artery island flap: a salvage option for head and neck reconstruction[J]. Maxillofac Plast Reconstr Surg, 2018,40(1):25-28.
[10] 吕晓智, 邵婷如, 赵萌 , 锁骨上动脉岛状皮瓣修复舌鳞癌术后缺损的临床研究[J]. 口腔疾病防治, 2016,24(7):386-389.
[11] Chan JW, Wong C, Ward K , et al. Three and four dimensional computed tomographic angiography studies of the supraclavicular artery island flap[J]. Plast Reconstr Surg, 2010,125(2):525-531.
[12] Giordano L, Di Santo D, Bondi S , et al. The supraclavicular artery island flap (SCAIF) in head and neck reconstruction:an Italian multiinstitutional experience[J]. Acta Otorhinolaryngol Ital, 2018,38(6):497-503.
[13] Giordano L, Di Santo D, Occhini A , et al. Supraclavicular artery island flap(SCAIF): a rising opportunity for head and neck reconstruction[J]. Eur Arch Otorhinolaryngol, 2016,273(12):4403-4412.
[14] Pallua N, Noah EM . The tunneled supraclavicular island flap: an optimized technique for head and neck reconstruction[J]. Plast Reconstr Surg, 2000,105(3):842-851.
[15] Sheriff HO, Mahmood KA, Hamawandi N , et al. The supraclavicular artery perforator flap: a comparative study of imaging technique used in preoperative mapping[J]. J Reconstr Microsurg, 2018,34(7):499-508.
[16] Gonzalez-Garcla JA, Chiesa-Estomba CM, Sistiaga JA , et al. Utility and versatility of the supraclavicular artery island flap in head and neck reconstrucion[J]. Acta Otorrinolaringol Esp, 2018,69(1):8-17.
[1] ZHANG Yu,JI Tong. Application of Indocyanine green in visual treatment of oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(2): 118-122.
[2] WANG Cuiping,WANG Mengxi,LV Bo. Depression status of 136 patients with adjuvant radiotherapy after reconstruction of the oral cancer flap and analysis of influencing factors [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2019, 27(11): 723-728.
[3] Guiqing LIAO, Huanzi LU. Methods for assessing dysphagia related to oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(6): 341-346.
[4] Qian TAO, Xin LIU. Salivary transcriptomics and biomarkers of oral squamous cell carcinoma [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(4): 211-217.
[5] ZHENG Yaowen,JIANG Lili,HU Jiale,RUAN Hong. Clinical characteristics and oral care needs of perioperative patients with oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(12): 799-807.
[6] Hong-zhang HUANG, Cheng WANG. Consideration of precision medicine and big data in oral cancer [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(5): 273-281.
[7] Ji ZHANG,Zhong-yuan YANG,Xing ZHANG,Shu-wei CHEN,Fan GAO,Xi-di WANG,Ming SONG. A 50 years' single-center analysis of epidemiologic characteristics of oral cancer in Guangdong Province [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(1): 13-20.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Hong-chang LAI,Jun-yu SHI. Maxillary sinus floor elevation[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(1): 8 -12 .
[2] Pin ZHOU, Yang-fei LI. MRI study of temporomandibular joint disc position in asymptomatic volunteers[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(4): 239 -244 .
[3] Xinxin XIA, Fang FANG, Lijuan CHENG. Shaping ability of Pathfile and WaveOne in simulated root canals[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(6): 365 -368 .
[4] Yuanhong LI, Xinyi FANG, Yu QIU, Lei CHENG. Experimental study on the effects of green tea on salivary flow rate and pH value[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(9): 560 -564 .
[5] Chengzhang LI. Masticatory muscles in occlusion[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(12): 755 -760 .
[6] . [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(1): 1 .
[7] Zhirong WU, Shiguang Huang. Research progress on the etiology, clinical examination and treatment of peri-implantitis[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(6): 401 -405 .
[8] Xiaowu YAO, Shisheng CHEN, Zizheng LU, Minxiao LIN. Clinical report and literature review on the amyloidosis of salivary glands[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(8): 533 -536 .
[9] Lan LIAO, Lijun ZENG. Updated research on digitalization in aesthetic restoration[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2018, 26(7): 409 -414 .
[10] Yu LU, Chengxia LIU, Zhongjun LIU. Role of TRAF6 in inflammatory responses of human osteoblast-like cells with Enterococcusfaecalis[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2017, 25(7): 420 -425 .
This work is licensed under a Creative Commons Attribution 3.0 License.