Application Of Pedicled Submandibular Gland Flap In Stoperative Repair Of Oral And Maxillofacial Malignant Tumors

Objective: To explore the application value and feasibility of pedicled submandibular gland flaps in repairing soft and hard tissue defects of oral and maxillofacial after oral and maxillofacial malignant tumor resection.Methods: A total of 10 patients aged 60 to 73 years,who were treated at the Oral and Maxillofacial Surgery of the Fourth Hospital of Hebei Medical University from October 2017 to December 2019,were planned for oral and maxillofacial malignant tumor resection and submandibular gland valve repair.Inferior and cervical CT,MRI,and ultrasound showed no suspected metastatic lymph node tissue on the same side of the primary lesion,and patients with small and medium defects were included.Follow-up observation was performed to analyze the flap survival,clinical repair effect,postoperative complications,and tumor recurrence and metastasis,to determine the indications of the primary lesion for the submandibular gland valve,and to guide clinical application.Results: A pedicled submandibular gland flap was used to repair one part of the right maxillary defect,one part of the right maxillary defect and part of the right buccal mucosal defect,one left mandibular body and left ascending branch of the left mandible,and one left One case of lateral mandibular body,ascending branch of mandible,and partial soft tissue of the floor of the mouth,one case of repair of the soft tongue of the right tongue and part of the bottom of the mouth,one case of soft tissue defect of the left cheek,one repair of soft tissue of the left cheek and part of the left and upper jaw In one case,one case was repaired in the right cheek soft tissue defect,one in the right oropharynx and part of the right cheek soft tissue defect,and one in the left oropharynx and part of the left cheek soft tissue defect.There were 0 cases of local necrosis,0 cases of early suture release,0 cases of corresponding sagittal ptosis caused by injury of the mandibular limb of the facial nerve,7 cases of wound healing in the first stage;3 cases of neck hematoma and concurrent wound infection;During the period of 3 to 24 months,2 patients were lost to follow-up,0 died,and 0 patients had local recurrence,neck metastasis,and distal organ metastasis.3 All patients' submandibular glands were alive,with atrophy and gradual mucosalization,and the mucosal surface was good.Among them,the oral and maxillofacial defects of 6 patients were not significantly different from the normal face,and the chewing,swallowing and speech functions were not much different from those of normal people.Oral endothelial flaps have reddish color,good mucosalization,and good repair effect.The chewing,swallowing,and speech functions of 4 patients were slightly different from normal people.The edges of the oral endothelial flaps were gray and partially mucousized.Oral and maxillofacial defects were basically repaired.Conclusion:The reconstruction technique of the pedicled submandibular gland flap can properly restore oral function,facial beauty and improve a certain quality of life.The pedicled submandibular gland flap is a relatively simple preparation,higher survival,better repair,and fewer postoperative complications.It can be used for patients with small oral or soft tissue defects or elderly patients with poor general condition after surgery.