口腔舌或口底重建的治疗路径：岛状面动脉黏膜肌瓣与游离股前外侧皮瓣的比较分析。
Treatment pathways for oral tongue or floor of mouth reconstruction: A comparative analysis of islanded facial artery myomucosal flap and free anterolateral thigh flap.
文献信息
| PMID | 42854362 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xiaozhen Lin |
| 作者单位 | Department of Stomatology, Hainan Hospital of Chinese People's Liberation Army General Hospital, 80 Jianglin Road, Sanya, Hainan 572013, China. Electronic address: dentlin@hotmail.com. |
| 期刊 | Oral oncology |
| SCI 分区 | Q1 |
| IF | 4.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 游离股前外侧（ALT）皮瓣是口腔舌（OT）或口底（FOM）鳞状细胞癌（SCC）切除后口内缺损重建的主要方法，但岛状面动脉黏膜肌瓣（iFAMM）已成为部分患者的替代选择。本研究比较了两种重建路径在cT1-2 N0 OT/FOM SCC患者中的围手术期结局、功能恢复和住院费用。
患者与方法： 这项单中心回顾性队列研究纳入了接受cT1-2 N0 OT/FOM SCC切除并使用iFAMM或游离ALT皮瓣重建的患者。比较了基线特征、手术时间、并发症、功能结局（张口度、吞咽、言语）、美学结局和住院费用，并计算效应量（95% CI）及进行多变量回归校正混杂因素。
结果： 在31例患者中，16例接受基于iFAMM皮瓣的路径治疗（iFAMM路径），15例接受基于游离ALT皮瓣的路径治疗（ALT路径）。虽然功能结局相当，但iFAMM路径显示手术时间更短（514.4 ± 66.2 vs. 602.6 ± 95.2 分钟，p = 0.005）、美学VAS评分更高（6.8 ± 1.5 vs. 4.9 ± 1.3，p = 0.001）且费用更低（8,848.7 ± 2,075.1 美元 vs. 14,212.5 ± 2,719.9 美元，p < 0.0001）。多变量回归证实基于皮瓣的路径是所有三项主要结局的独立预测因素。
结论： 对于cT1-2 N0 OT/FOM SCC的手术治疗，iFAMM路径似乎是ALT路径的一种有前景的替代方案，功能相当、美学更优且费用更低。这些探索性发现值得在前瞻性试验中证实。
英文摘要
PURPOSE: The free anterolateral thigh (ALT) flap is the mainstay for reconstructing intraoral defects after oral tongue (OT) or floor of mouth (FOM) squamous cell carcinoma (SCC) resection, but the islanded facial artery myomucosal (iFAMM) flap has emerged as an alternative for selected patients. This study compared perioperative outcomes, functional recovery, and hospitalization costs between the two reconstructive pathways in cT1-2 N0 OT/FOM SCC patients.
PATIENTS AND METHODS: This single-center retrospective cohort study included patients undergoing resection of cT1-2 N0 OT/FOM SCC with reconstruction using either the iFAMM or free ALT flap. Baseline characteristics, operative duration, complications, functional outcomes (mouth opening, swallowing, speech), esthetic outcomes, and hospitalization costs were compared, with effect sizes (95% CI) and multivariable regression adjusting for confounders.
RESULTS: Among 31 patients, 16 received iFAMM flap-based pathway treatment (iFAMM pathway) and 15 received free ALT flap-based pathway treatment (ALT pathway). While functional outcomes were comparable, the iFAMM pathway showed shorter operative time (514.4 ± 66.2 vs. 602.6 ± 95.2 min, p = 0.005), higher aesthetic VAS score (6.8 ± 1.5 vs. 4.9 ± 1.3, p = 0.001), and lower costs (8,848.7 ± 2,075.1 USD vs. 14,212.5 ± 2,719.9 USD, p < 0.0001). Multivariable regression confirmed flap-based pathway as an independent predictor for all the three primary outcomes.
CONCLUSION: The iFAMM pathway appears to be a promising alternative to the ALT pathway for surgical treatment of cT1-2 N0 OT/FOM SCC with comparable function, superior aesthetics, and lower costs. These exploratory findings warrant confirmation in prospective trials.