改良双侧扇形瓣修复下唇鳞状细胞癌术后缺损

Improved Bilateral Fan-Shaped Flaps for Repairing Postoperative Defects in Patients with Lower Lip Squamous Cell Carcinoma

摘要: 唇癌是一种影响口腔颌面部外观和功能的非常见肿瘤，90%以上发生在下唇。唇癌的首选治疗方法是手术切除。然而，使用扇形皮瓣修复唇癌术后缺损的方法很难统一且难以掌握。本研究选择了2008年1月至2023年12月在我院口腔颌面外科治疗的16例下唇鳞状细胞癌患者。所有患者均接受了根治性肿瘤切除术，并采用改良双侧扇形瓣重建缺损。所有患者出院时均有较为严重的张口受限，有2名患者在为期两年的随访期间因自觉张口受限影响日常生活而接受了小口畸形开大手术，其余患者均恢复至中度或轻度张口受限，所有患者均获得了满意的功能及美观疗效。因此，本研究采用的改良双侧扇形瓣修复下唇鳞状细胞癌切除术后缺损能最大限度地修复唇部的美学和功能，是一种在精确算法下可靠的手术方法。但这种改良皮瓣的疗效和适应证还需要更多的数据来验证，以最大限度地改善术后口腔的美观和功能。

Abstract: Lip cancer is a rare tumor that affects the appearance and function of the oral and maxillofacial region, with over 90% of cases occurring on the lower lip. The preferred treatment for lip cancer is surgical resection. However, the method of using fan-shaped flaps to repair the postoperative defect of lip cancer is difficult to standardize and master. This study selected 16 patients with squamous cell carcinoma of the lower lip who were treated in the Department of Oral and Maxillofacial Surgery of our hospital from January 2008 to December 2023. All patients underwent radical tumor resection, and the defect was reconstructed using an improved bilateral fan-shaped flap. All patients had severe trismus at discharge. 2 patients underwent microstomia dilation surgery during the two-year follow-up period due to self-perceived limited mouth opening that affected their daily life, the remaining patients recovered to moderate or mild trismus. All patients achieved satisfactory functional and aesthetic outcomes. Therefore, the improved bilateral fan-shaped flap used in this study to repair the defect after resection of squamous cell carcinoma of the lower lip can restore the aesthetics and function of the lip to the greatest extent and is a reliable surgical method under precise algorithm. However, the efficacy and indications of this improved flap still require more data for verification to maximize the improvement of postoperative oral aesthetics and function.