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

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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 无 6.5/500 ASAⅠ 无 无
2 66/F 颊/SCC/T2N0M0 IND 6 × 6 无 4.5/400 ASAⅡ 高血压 无
3 68/F 下牙龈/SCC/T3N0M0 IND 6 × 8 无 6/450 ASAⅠ 无 无
4 69/M 舌/SCC/T4N1M0 BND 7 × 9 无 6.5/500 ASAⅡ 冠心病 肺炎
5 77/F 颊/SCC/T3N0M0 IND 6 × 8 无 4.5/400 ASAⅠ 无 无
6 70/M 舌/SCC/T2N0M0 IND 4 × 6 皮岛坏死 4.5/400 ASAⅠ 无 无
7 66/M 下牙龈/SCC/T3N1M0 IND 5 × 7 无 5/400 ASAⅠ 无 无
8 82/F 舌/SCC/T2N0M0 IND 4 × 6 无 4.5/300 ASAⅡ 冠心病,高血压 无
9 65/M 舌/SCC/T3NIM0 IND 6 × 8 无 4.5/450 ASAⅠ 无 无
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 无
12 66/M 口底/ACC/T2N0M0 IND 4 × 5 无 4.5/400 ASAⅡ 高血压 无
13 68/M 舌/SCC/T4N0M0 BND 6 × 8 无 6.5/500 ASAⅡ 冠心病,高血压 无
14 75/M 口底/SCC/T3N0M0 BND 6 × 7 无 6/450 ASAⅡ 糖尿病 无
15 70/F 颊/SCC/T3N0M0 IND 5 × 7 无 5/400 ASAⅠ 痛风 无
16 69/F 上牙龈/SCC/T3N0M0 IND 6 × 8 远端坏死 5/500 ASAⅡ 高血压,糖尿病 无
17 76/M 舌/SCC/T2N0M0 IND 4 × 5 无 5/400 ASAⅠ 无 无
18 80/M 舌/SCC/T3N0M0 IND 5 × 7 无 5/400 ASAⅢ 冠心病,高血压 心衰
19 70/M 颊/SCC/T2N0M0 IND 5 × 6 无 4.5/300 ASAⅠ 无 无
20 68/F 上牙龈/SCC/T3N0M0 IND 6 × 7 无 4.5/400 ASAⅠ 无 无
21 81/M 腭/ACC/T2N0M0 IND 5 × 6 无 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 无
23 79/M 下牙龈/SCC/T2N0M0 IND 5 × 6 无 4.5/400 ASAⅡ 冠心病 无
24 72/M 舌/SCC/T3NIM0 IND 6 × 7 无 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"

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