Objective: To report 4 methods of reconstructing soft tissue defects in oral and maxillofacial regions after tumors resection using cervical pedicle tissue flaps.
Methods: One hundred seventy-two soft tissue defects were repaired with cervical myocutaneous flaps after resection of oral and facial cancer (165 cases of squamous cell carcinoma and 7 cases of salivary carcinoma). The clinical stage of the tumors was stage I in 21 cases, stage II in 116 cases and stage III in 35 cases. Primary sites of the lesions were the tongue (59 cases), buccal mucosa (55 cases), lower gingiva (26 cases), floor of the mouth (25 cases), parotid gland (4 cases) and oropharynx (3 cases). Infrahyoid myocutaneous flaps were used in 60 cases, platysma flaps in 45 cases, sternocleidomastoid flaps in 59 cases and submental island flaps in 8 cases. The sizes of skin paddle ranged from 2.5 cm x 5.0 cm to 5.0 cm x 8.0 cm.
Results: Among 153 survival flaps, there were 55 infrahyoid myocutaneous flaps, 40 platysma flaps, 52 sternocleidomastoid flaps and 6 submental island flaps. There were 11 cases of total flap necrosis and 8 cases of partial flap necrosis. The success rates were 91.67% (55/60) for infrahyoid myocutaneous flap, 88.89% (40/45) for platysma flap, 88.14% (52/59) for sternocleidomastoid flap and 75% (6/8) for submental island flap. After a follow-up of 3 11 years (5.7 years on average) among 101 cases local recurrence in 18 cases, cervical recurrence in 4 cases, distance metastasis in 2 cases. The survival rate at 3 years were 83.17% (84/101).
Conclusion: Cervical pedicle tissue flaps have clinical value in reconstruction of small and medium-sized soft tissue defects after resection of oral and maxillofacial tumors.