| Objective: To compare the clinical effects of repairing oral and maxillofacial defects with facial arterial musculocutaneous flaps and anterolateral femoral flaps.Methods: Patients with oral and maxillofacial tumors were selected after tumor resection in our hospital from July,2016 to June,2017.After screening,a total of 57 patients were selected,and the patients were divided into observation group and control group according to the types of skin flaps used to repair tongue and oral floor defects after tumor resection randomly.In the observation group,the defect was repaired with facial arterial musculocutaneous flaps,while in the control group,the defect was repaired with anterolateral femoral flaps.Postoperative survival of the flap and wound healing stage were observed,and postoperative conditions such as limited mouth opening,dysphagia,abnormal sensation in the operative area and postoperative complications were recorded.The reconstructed area was comprehensively evaluated by the scale,and the mental health degree influence scale（Chinese version of ohip-14）was adopted 3months after the operation for evaluation.Results: By comparing the prognosis of the two groups,the flap survival rate of the observation group was 100.00%,and that of the control group was92.59%.The flap survival rate of the observation group was higher than that of the control group,and the difference was statistically significant（P<0.05）.In the control group,2 cases of skin flap occurrence vascular crisis immediately after the second surgery to replace the forearm flap repair,postoperative skin flap growth is good.The first-stage wound healing rate in the observation group was significantly higher than that in the control group,and the difference was statistically significant（P<0.05）.There was no statistically significant difference between the observation group and the control group in prognostic indicators such as normal postoperative mouth opening（>3 horizontal finger）rate,required mouth opening training rate and swallowing disorder rate（all P>0.05）.Abnormal skin color or hair growth rate in the observation group was significantly lower than that in the control group,and the difference was statistically significant（P<0.05）.The scores of sublingual lift,forward extension and left and right motor function were significantly higher than those of femoral anterolateral skin flap repair.The satisfaction score,texture score and surface score of the skin flap were significantly higher than those of the femoral anterolateral skin flap repair.The quality of life of the patients after transplantation of the two types of skin flaps was compared by using chewing efficiency,swallowing function,oral volume,swollen gills,and the ability to wear dentures.The differences in scores of the two types of patients were not statistically significant.The speech articulation and language ability,the texture of the flap and the surface of the flap were significantly higher than that of the anterolateral thigh flap.Conclusions: The facial artery mucosa myocutaneous flap is simple and easy.The reconstructive surgery effect is ideal.The flap survival rate is higher with the less postoperative complications,injury and postoperative nursing.The facial artery mucosa myocutaneous flap is a reliable flap to repair the bottom of the mouth and tongue defects,and the wound skin mucous membrane has good texture and color matching with the surrounding skin mucous membrane.The patients’ oral and maxillofacial morphology and aesthetic effect is satisfied.The clinical application value is big and worth promoting.Compared with other types of skin flaps,using facial arterial myocutaneous flaps to repair oral and lingual defects can improve patients’ quality of life and mental health.If the tissue volume of facial arterial mucosa musculocutaneous flaps is insufficient,the defect area of tongue and oral floor should not be larger than 5cm by 5cm,but it can be solved by combined use of bilateral arterial mucosa musculocutaneous flaps. |
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