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

摘要：

目的 探讨以颈横动脉供血的延长锁骨上皮瓣在老年口腔癌患者术后软组织缺损修复中的临床应用效果。方法 对2015年1月—2018年6月在海南省人民医院口腔颌面外科收治24例老年口腔癌患者,其中男15例,女9例,年龄65~82岁,平均年龄71.8岁,全部采用延长锁骨上皮瓣对口腔癌根治切除后软组织缺损进行同期修复,皮瓣最小4 cm × 6 cm,最大7 cm × 9 cm。术后6个月对所有患者进行华盛顿大学生存质量问卷（university of Washington quality of life questionnaire, UW-QOL）调查,同时进行患者主观的满意度调查。结果 延长锁骨上皮瓣存活率为91.6%（22/24）,患者术后言语、吞咽功能良好,供区疤痕隐蔽,供区无明显后遗症,术后6个月患者UW-QOL总分平均分为76.5 ± 6.4,术后随访效果满意度为87.5%（21/24)。结论 以颈横动脉供血的延长锁骨上皮瓣血运可靠,厚薄适中,操作简单、对供区创伤小,供区相对隐蔽,适合同期修复老年口腔癌患者术后软组织缺损。

关键词: 口腔癌, 老年患者, 锁骨上皮瓣, 缺损修复, 筋膜皮瓣, 颈横动脉, 轴形皮瓣