1
|
Wang LM, Tian YY, Liu XM, Cao Y, Sui L, Mao C, Liu H, Ye JH, Zhou YS, Peng X, Ye HQ, Yan YB. Quality of life in patients with cancer-related Brown IIb maxillary defect: A comparison between conventional obturation rehabilitation and submental flap reconstruction. Oral Oncol 2022; 132:105980. [PMID: 35749804 DOI: 10.1016/j.oraloncology.2022.105980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/17/2022] [Accepted: 06/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this retrospective study was to compare the differences in quality of life (QOL) outcomes between the conventional obturator prostheses (COP) and the pedicled submental artery island flap (SAIF) in the reconstruction of Brown IIb maxillary defects. MATERIALS AND METHODS The QOL of 116 eligible patients who had a lapse ≥ 12 months after the cancer-related maxilla ablation was evaluated by the University of Washington quality of life scale (UW-QOL), Performance Status Scale for Head and Neck (PSS-HN), and Obturator Functioning Scale (OFS). RESULTS Patients in the SAIF group reported statistically and clinically significant higher overall QOL scores but lower chewing scores in the UW-QOL scale when compared with those in the COP group (P < 0.05). Clinically significantly higher scores were also observed in the recreation and anxiety domains in the UW-QOL scale for the SAIF group, but there was no statistical significances. The COP group reported more complaints about the nasal leakage when swallowing and the shape of the upper lip, and had a stronger willingness to avoid family or social events in the OFS (P < 0.05). CONCLUSIONS For patients with Brown IIb defects, SAIF reconstruction can achieve reduced nasal leakage when swallowing, improved upper-lip contour, increased social activity, and superior overall QOL than COP. The inferior chewing function in the SAIF group indicated the need for dental rehabilitation with a conventional denture or osseointegrated implants.
Collapse
Affiliation(s)
- Li-Mei Wang
- Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China
| | - Yuan-Yuan Tian
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Xiao-Ming Liu
- Department of Prosthodontics, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Ye Cao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Lei Sui
- Department of Prosthodontics, Stomatological Hospital of Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China
| | - Chi Mao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Hao Liu
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Jia-Hui Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Yong-Sheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Hong-Qiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Ying-Bin Yan
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China.
| |
Collapse
|
2
|
Modified Reconstruction of Brown II Defects With Anterolateral Thigh Flaps Following Tumor Resection. J Craniofac Surg 2022; 33:e509-e513. [PMID: 35132034 DOI: 10.1097/scs.0000000000008536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Maxillary defects reconstructed with flaps usually cause nasalomaxillary fistula, discomfort oral lining, and poor function of denture. To resolve these problems, this study introduces a modified method of anterolateral thigh flap (ALTF) with skin and myofascial paddles to reconstruct nasal and oral lining of maxillary defects. METHODS This study retrospectively reviewed 66 consecutive patients of Brown II maxillary defects following tumor resection reconstructed with ALTFs of modified or conventional methods. In modified group, oral lining was reconstructed with myofascial paddle and nasal lining was reconstructed with skin paddle. The functional and aesthetic outcomes, and the scores based on the University of Washington quality of life questionnaire were assessed. RESULTS All flaps were successful in reconstruction of Brown II maxillary defects. No nasalomaxillary fistula and obstruction of the nasal cavity were found in modified ALTFs group. The functions of removable denture were better in modified ALTFs group. There was no significant difference about tumor recurrence, range of mouth opening, and aesthetic outcomes between the 2 groups. CONCLUSIONS The modified method of ALTF with skin and myofascial piddle to reconstruct Brown IIa and IIb defects following tumor resection is simple and reliable, which improves the oral comfortability and function of denture, and avoids obstruction of the nasal cavity.
Collapse
|
3
|
Hanson-Viana E, Rendón-Medina MA, Mendoza-Vélez MDLÁ, Pacheco-López RC, Palacios-Juárez J. Refinements of the submental island flap donor site: a literature review and comparison among surgical specialties. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01813-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
4
|
Seim NB, Ozer E, Valentin S, Agrawal A, VanPutten M, Kang SY, Old MO. Custom Presurgical Planning for Midfacial Reconstruction. Facial Plast Surg 2020; 36:696-702. [PMID: 33368124 DOI: 10.1055/s-0040-1721812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Resection and reconstruction of midface involve complex ablative and reconstructive tools in head and oncology and maxillofacial prosthodontics. This region is extraordinarily important for long-term aesthetic and functional performance. From a reconstructive standpoint, this region has always been known to present challenges to a reconstructive surgeon due to the complex three-dimensional anatomy, the variable defects created, combination of the medical and dental functionalities, and the distance from reliable donor vessels for free tissue transfer. Another challenge one faces is the unique features of each individual resection defect as well as individual patient factors making each preoperative planning session and reconstruction unique. Understanding the long-term effects on speech, swallowing, and vision, one should routinely utilize a multidisciplinary approach to resection and reconstruction, including head and neck reconstructive surgeons, prosthodontists, speech language pathologists, oculoplastic surgeons, dentists, and/or craniofacial teams as indicated and with each practice pattern. With this in mind, we present our planning and reconstructive algorithm in midface reconstruction, including a dedicated focus on dental rehabilitation via custom presurgical planning.
Collapse
Affiliation(s)
- Nolan B Seim
- Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Enver Ozer
- Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Sasha Valentin
- Department of Dentistry - Maxillofacial Prosthodontics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Amit Agrawal
- Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Mead VanPutten
- Department of Dentistry - Maxillofacial Prosthodontics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Stephen Y Kang
- Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Matthew O Old
- Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| |
Collapse
|
5
|
Scarano A, Lorusso F, Di Cerbo A, Lucchina AG, Carinci F. Eradication of hairy mouth after oncological resection of the tongue and floor mouth using a diode laser 808 nm. Postoperative pain assessment using thermal infrared imaging. Lasers Surg Med 2019; 51:516-521. [PMID: 30614012 DOI: 10.1002/lsm.23054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Vascularized soft tissue flaps are often harvested from hair-bearing areas, such as the radial forearm or anterolateral thigh, making their use in oral reconstruction problematic due to postoperative hair growth. The presence of intact hair follicles in free tissue transfer and continued hair growth at the recipient site can result in difficulties with oral hygiene, intraoral irritation, food trapping, and patient distress. This study was to evaluate the intraoral efficacy and safety of a diode laser 808 nm when used for hair removal. MATERIALS AND METHODS Sixteen male patients, between 2010 and 2017, were referred for intraoral hair eradication with a history of squamous cell carcinoma of the tongue or floor mouth resection. An 808 nm diode laser (Stark 808, Plume s.r.l., Rome, Italy) was used to remove the intraoral hair. Each patient received a total of six treatments at 4-week intervals. Perifollicular pain was quantified by the physician using visual analog scales. Follow-up visits were scheduled at 1, 4, and 6 days to check the state of the tissues. The recall program included assessments of VAS, erythema, and perifollicular temperature. Patients were followed up for long-term assessments at 6 and 12 months after the final treatment session. RESULTS All patients presented well with no occurrence of symptoms, indicating possible perifollicular inflammation. Based on the VAS scores, very mild discomfort during laser irradiation was recorded in all patients, with average pain score of 10.98 ± 1.42. No pain or discomfort was recorded 1, 4, and 6 days after the procedure. After the third pulse of light was applied, the average temperature with standard deviation of the hair tip with both the dark and light skin was 74.4 ± 11.7°C. The difference in temperature before the procedure (basal measurement 37.5 ± 2.8°C) and immediately after laser irradiation was 36.9 ± 3.7°C. The difference in temperature disappeared after 0.29 seconds, and no temperature increase was recorded on days 1, 4, or 6. In all the patients, the hair clearance between baseline and the 6th treatment, the 6-month follow-up, and the 12-month follow-up rated as significant P < 0.05. The mean percentage of hair reduction was 97.3% at 12 months. CONCLUSION In conclusion, the clinical findings demonstrate the safety and efficacy of the 808 nm diode laser system for intraoral hair removal Lasers Surg. Med. 51:516-521, 2019. © 2019 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSi Met, University of Chieti-Pescara, Chieti, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences and CeSi Met, University of Chieti-Pescara, Chieti, Italy
| | - Alessandro Di Cerbo
- Department of Medical, Oral and Biotechnological Sciences and CeSi Met, University of Chieti-Pescara, Chieti, Italy.,Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberta Greco Lucchina
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.,University of Eastern Piedmont, Novara, and Oral Surgery Unit, Regina Margherita Pediatric Hospital, Turin, Italy
| | - Francesco Carinci
- Department of Morphology, Experimental Medicine and Surgery, University of Ferrara, Ferrara, Italy
| |
Collapse
|
6
|
Reconstruction with submental flap for aggressive orofacial cancer- an updated series. Am J Otolaryngol 2018; 39:693-697. [PMID: 30076021 DOI: 10.1016/j.amjoto.2018.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/24/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE Submental flap is gaining popularity for head and neck reconstruction. We have reported in 2007 our early experience of using submental flap for aggressive orofacial malignancy. Novel flap design and application is described in this updated series. MATERIALS AND METHODS 15 patients who had received submental flap reconstruction after extirpation of newly diagnosed aggressive orofacial lesions were retrieved. The details of the flap harvest was studied for flap size, inclusion of mylohyoid muscle, antegrade versus retrograde blood supply, and compared with our previous series. RESULTS The dimension of flap skin paddle was 30cm2 (range 20-72). Retrograde pedicle flow was used in 2(13.3%) patients. Mylohyoid muscle was included in the flap in 6(40%) patients. There was no total flap necrosis while partial flap necrosis occurred in 1 patient(6.7%). There was a significant increase of inclusion of mylohyoid muscle to the flap in this series (p = 0.02). Novel techniques including double-paddled flap skin to resurface full-thickness defect and chimeric osteocutaneous mandible submental flap for maxillary defect were successfully performed. CONCLUSIONS Submental flap is a viable reconstructive option in selected patients with aggressive orofacial malignancy. The indications are expanding and its technical modification is evolving and resulting in more innovative applications.
Collapse
|
7
|
Eskander A, Kang SY, Teknos TN, Old MO. Advances in midface reconstruction: beyond the reconstructive ladder. Curr Opin Otolaryngol Head Neck Surg 2017; 25:422-430. [DOI: 10.1097/moo.0000000000000396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
8
|
Wiedermann JP, Romero N, Shah RK, Preciado D, Cohn JE, Kieliszak CR, Joshi AS. Novel case examples of the submental island flap in pediatric head and neck reconstruction. Int J Pediatr Otorhinolaryngol 2017; 97:51-54. [PMID: 28483251 DOI: 10.1016/j.ijporl.2017.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 03/15/2017] [Accepted: 03/18/2017] [Indexed: 11/29/2022]
Abstract
The submental island flap was first described as a tool for facial reconstruction after tumor resection. It is now widely used for reconstructing numerous structures in the head and neck region of adults. Pediatric surgical reconstruction is a challenging task that continues to evolve over time. We describe two novel uses of this flap in the pediatric population. The submental island flap is an excellent option for reconstruction in pediatrics given its ease of elevation, excellent cosmetic outcomes, and low donor site morbidity.
Collapse
Affiliation(s)
- Joshua P Wiedermann
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health, Washington DC, United States
| | - Nahir Romero
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health, Washington DC, United States
| | - Rahul K Shah
- Children's National Medical Center, Department of Pediatric Otolaryngology-Head and Neck Surgery, Washington DC, United States
| | - Diego Preciado
- Children's National Medical Center, Department of Pediatric Otolaryngology-Head and Neck Surgery, Washington DC, United States
| | - Jason E Cohn
- Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia PA, United States
| | - Christopher R Kieliszak
- Department of Otolaryngology-Head and Neck Surgery, OhioHealth Doctors Hospital, Columbus OH, United States.
| | - Arjun S Joshi
- Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health, Washington DC, United States
| |
Collapse
|
9
|
Rahpeyma A, Khajehahmadi S. A Protocol for Management of the Hairs Problem in Oral Cavity Reconstruction by Submental Flap. J Maxillofac Oral Surg 2016; 16:108-112. [PMID: 28286394 DOI: 10.1007/s12663-016-0925-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 05/21/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Submental flap is a useful aid in maxillofacial reconstruction. For intraoral usage the hairs in male patients will create some problems. MATERIALS AND METHODS In a retrospective study, patients in whom submental flap had been used for reconstruction of orofacial region between 2007 and 2013, in the Mashhad University, Ghaem Hospital, were included. The ways in which the problem of hairs was solved in male patients were evaluated. RESULTS There were 42 patients in whom submental flap was used for orofacial reconstruction. Sixty percent were males. Three ways had been used for management of intraoral hairs: radiotherapy (9 patients), second surgery (2 patients) and flap de-epithelialization (13 patients). CONCLUSION Deepithelialized variant of submental flap is the best option when submental flap is used for oral cavity reconstruction in male patients. Flap thickness, age, race and postoperative radiotherapy can have strong influence on this strategy.
Collapse
Affiliation(s)
- Amin Rahpeyma
- Oral and Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, P.O. Box: 91735-984, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, P.O. Box: 91735-984, Mashhad, Iran
| |
Collapse
|
10
|
Rahpeyma A, Khajehahmadi S. Developing an Algorithm for Reconstruction of Full Thickness Cheek Defect by Submental Flap. Am Surg 2015. [DOI: 10.1177/000313481508101203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Amin Rahpeyma
- Maxillofacial Surgery Oral and Maxillofacial Diseases Research Center School of Dentistry, Mashhad University of Medical Sciences Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Maxillofacial Pathology Dental Research Center School of Dentistry, Mashhad University of Medical Sciences Mashhad, Iran
| |
Collapse
|
11
|
Bertrand B, Foletti JM, Noël W, Duron JB, Bardot J. [Submental island flap: a review of the literature]. ANN CHIR PLAST ESTH 2014; 60:44-53. [PMID: 25213485 DOI: 10.1016/j.anplas.2014.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/20/2014] [Indexed: 10/24/2022]
Abstract
The submental island flap is a precious tool in reconstructive surgery. It was described by Martin in 1993, inspired by platysma flaps. In our days, we can find many reliable techniques for this procedure. We reviewed the main studies of the literature that described a total of 528 patients. The rate of partial necrosis was 5.1%, complete necrosis 1.7%, and reversible lesions of the marginal mandibular branch of the facial nerve 1.1%. His versatility makes this flap appropriate for the reconstruction of every part of the face: cheeks, nose, forehead, moustache, beard, and hairs. It can also be used de-epidermised with very good results, for the reconstruction of the buccal cavity, the tongue, the roof of the mouth, the larynx, and the proximal part of the esophagus. The SMAP (Submentalis Artery Perforator flap) is an alternative flap that provides even better cosmetic results. The development of indocyanine green and infrared cameras will allow in a close future to decrease the postoperative complications.
Collapse
Affiliation(s)
- B Bertrand
- Service de chirurgie plastique reconstructrice et esthétique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France.
| | - J-M Foletti
- Aix-Marseille université, 13284 Marseille, France; Service de chirurgie maxillo-faciale et plastique de la face, AP-HM, hôpital Nord, 13915 Marseille cedex 20, France
| | - W Noël
- Service de chirurgie plastique, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - J-B Duron
- Service de chirurgie plastique, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - J Bardot
- Service de chirurgie plastique reconstructrice et esthétique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| |
Collapse
|