The Feasibility That Primary Tumor Contralateral Submental Island Myocutaneous Flap Reconstruct Oral Squamous Cell Carcinomas (OSCC) Tissue Defect

Objective: To study the feasibility that primary tumor contralateral submental island myocutaneous flap reconstruct oral squamous cell carcinomas(OSCC)tissue defect,in order to increase the choice of clinical workers.Methods: There were 14 patients in The forth affiliated hospital of hebei medical university between November 2013-January 2016,including 12 cases of tongue toumor and 2cases of up gum.They were confirmed OSCC preoperatively.Age 45-71.They were repaired by primary tumor contralateral submental island myocutaneous flap after tumor resrction.Through follow-up observation,we analysized the success rate,repair effect,postoperative complications and recurrence and metastasis of tumor,in order to determine indication of the primary tumor contralateral submental island myocutaneous flap and to guide clinical application.Results: There was no appearance of the flap necrosis,the success rate was 100%.1 case with toungue OCSS appeared neck hematoma after postoperative 1 hour,to probe bleeding in the operating room.After 4 days,the patient appeared high fever symptom,ande the wound had pus overflow.After carefull inspection,the patient was diagnosed infection.According to the drug sensitive test,we adopted antibiotic treatment,combining with local drainage,hydrogen peroxide and normal saline switching alternately and article iodoform gauze tamponade,2times per day.After 2 months,the wound healed basically.Nobody appeared quarrel prolapsed symptoms at corresponding side because of marginal mandibular branch of facial nerve damage.Nobody appeared lower lip evaginate and cat ear malformation.After follow –up,1case of the gingival OCSS T2N2 b M0 appeared second primarytumor and systemic metastasis,eventutally died.1 case of toungue OCSS lost to follow-up.The rest of the patients with no local recurrence and neck metastasis occurred.Conclusions: The primary tumor contralateral submental island myocutaneous flap is reliable,simple,effective,high success rate,and less postoperative complications.It can be used in patients with suspicious lymph node metastasis of primary tumor ipsilateral.If the patients with high suspicious lymph node metastasis of pimary tumor contralateral according to preoperative examination,we should be carefull.