Objective To evaluate the clinical outcomes of submental island pedicled flap (SIPF) combination with bio-membrane in reconstructing palate defects after maxillofacial or palatal neoplasm resection.Methods There were 12 patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma.The clinical stages of tumours were]] in two patients,Ⅲ in four patients,Ⅳ in six patients(UICC 2002),and one patient with adenoid cystic carcinoma no staged.SIPFs were designed and created,and the tissue sides of the SIPFs were covered with bio-membrane to reconstruct the oral and the nasal sides of the defects respectively.Speech and swallowing functions and opening mouth were evaluated 6 months postoperatively.Results All flaps survived and no serious complications occurred.Ten patients achieved normal speech,two had intelligible speech,and one was with slurred speech;Nine patients resumed a solid diet,three with a soft diet,and one on a liquid diet.Eight patients recovered normal mouth opening,four emerged minor limitation of mouth opening,and one had serious limitation of mouth opening.Conclusions SIPF combined with bio-membrane is a safe,simple,and reliable method for reconstruction of piercing palate defect following neoplasm ablation,with satisfactory oral functions.%目的 探讨采用颏下岛状皮瓣联合口腔修复膜重建腭部洞穿型缺损的临床效果.方法 2010年8月至2014年2月,南京医科大学附属淮安一院口腔科共完成13例上颌牙龈或腭部恶性肿瘤患者的手术治疗,其中病理诊断为鳞状细胞癌12例,腺样囊性癌1例;肿瘤临床分期为:Ⅱ期2例,Ⅲ期4例,Ⅳ期6例,未分期1例.对肿瘤扩大切除后所遗留的腭洞穿型缺损应用颏下岛状皮瓣进行重建,并用口腔修复膜重建缺损的鼻腔面.对重建后患者的语音,吞咽功能及开口度进行评价.结果 13例皮瓣全部成活,无手术相关的严重并发症发生;术后10例患者的语音功能恢复正常,2例有轻度语音功能障碍,1例重度语音障碍;9例患者恢复正常饮食,3例可进食软食,1例能进流质;有8例患者恢复正常开口,发生轻度开口受限4例,重度开口受限1例.结论 应用颏下岛状皮瓣联合口腔修复膜修复可能是一种重建腭部洞穿型缺损简单、安全、可靠的方法,并可获得较为满意的口腔功能恢复.
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