Clinical Application Of CTA Combined With CDU Assisted Anterolateral Thigh Perforator Flap In Repairing And Reconstructing Defects After Tongue Cancer Operation

Objective:Tissue defect after tongue cancer operation seriously affects the quality of life of patients,which requires improving the survival rate and quality of life at the same time.We use computed tomography(CTA),color Doppler ultrasound(CDU)and their combination to design anterolateral thigh perforator flap for tongue reconstruction,and seek the best reconstruction of tongue defect with the least damage.Methods:Select the Department of Stomatology of the First Affiliated Hospital of Bengbu Medical College from July 2017 to September 2020,and conduct a comparative study on 40 patients with postoperative defects of tongue cancer.According to the situation,the patients are divided into three groups: 20 patients in Group A were treated with CTA combined with CDU before operation,10 patients in Group B were treated with CTA,and 10 patients in Group C were treated with CDU to evaluate the perforating branch and course of external circumflex femoral artery.According to the amount of tissue defect,the patients were designed with personalized flaps,and flap repair was performed at the same time during the operation.Meanwhile,Fisher accurate probability method was used to analyze the coincidence rate of perforating fulcrum and perforating branch types in the three groups.Variance analysis was used for flap preparation time and postoperative hospitalization days,with P < 0.05 being statistically significant.The patients were followed up for 3-6 months,and the recovery of tongue function was evaluated by variance analysis.Results:All the flaps of 37 patients survived,and 1 case in Group A was partially necrotic and the muscle flap survived.One patient in group B and group C still died of venous crisis after rescue.There is a significant difference between group A and group C in the coincidence rate of perforating branches(P=0.002),and the time of skin flap preparation in group a is obviously better than that in groups B and group C(P=0.004),but there is no significant difference in the coincidence rate of perforating branches(P=0.244)and postoperative hospitalization days among the three groups(P=0.845).Primary healing of donor and recipient incision after operation;Satisfactory results were achieved in tongue shape and function recovery,and no obvious complications were found in donor and recipient areas.Three groups of patients recovered well three months after the operation,but there was no significant difference in functional recovery after operation.(P > 0.05).Conclusion:The design of anterolateral thigh flap assisted by CTA and CDU has a good guiding significance for repairing postoperative defects of tongue cancer,because it can plan the operation in advance before operation,and has the advantages of reasonable utilization of donor site and satisfactory recovery of shape and function of recipient site,which can provide guidance for individualized repair of patients with different types of tongue defects,and strive to achieve the best repair effect of recipient site with less donor site injury.