口腔疾病防治 (Jun 2016)
Application of platysma myocutaneous flap in repairing the defect after resection of buccal carcinoma
Abstract
Objective To investigate the application value of platysma myocutaneous flap in repairing the defect after resection of buccal carcinoma.Methods 40 patients (preoperative examination of regional lymph nodes showed no obvious metastases of buccal cancer) were selected during January 2008 to May 2014, 40 patients were divided into the observation group and control group equally and received the conventional implement buccal carcinoma resection and selective neck dissection. Observation group used platysma myocutaneous flap to repair the buccal defect, and the control group used forearm skin flap to repair the defect. After one year follow-up, the survival rate of the flaps, the neck activity after operation, and the opening degree of mouth were compared with these two groups.Results Compared with the control group, the survival rate of the observation group had no statistically significant difference (χ2 = 0.013, P = 0.909). In the observation group, the flap surrounding the mandible had a significant lower incidence of distal necrosis than that without surrounding the mandible, and the difference was statistically significant (χ2 = 3.429, P = 0.044). 1 years after the operation, the scar was softened, and there was no significant difference between the two groups. The mouth opening degree and buccal flap mucosal condition were ideal 1 year later, the difference was not statistically significant between the two groups (P > 0.05).Conclusion Platysma myocutaneous flap has good repairing effect for the preoperative defect in buccal cancer patients without dominant buccal and submandibular lymph node metastasis. It is especially suitable for the patients with missing teeth after resection of buccal lesions and patients who can not implement the free flap with high surgical risk. Compared with free flap, platysma myocutaneous flap has the advantages of small surgical trauma, good efficacy, simple operation and easy to carry out, it’s worthy of clinical promotion.
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