ĐÁNH GIÁ KỸ THUẬT SỬ DỤNG VẠT MŨI MÁ TRONG TÁI TẠO KHUYẾT HỔNG KHOANG MIỆNG

Abstract

Introduction: Reconstructing defects after the surgical removal of invasive oral cavity cancer is always a challenge in head and neck surgery. These defects need to be reconstructed anatomically and functionally to optimize oral cavity functions such as speech, chewing, swallowing, and aesthetics. The nasolabial flap is a skin-muscle flap based on the vascular pedicle of the face, offering advantages in terms of color, robustness, flexibility, and discreet scarring at the donor site. Objectives: To evaluate the technique of using nasolabial flaps for reconstructing defects at Cho Ray Hospital from January 2020 to October 2023. Patients and methods: A prospective interventional clinical study without a control group. The study involves 32 cases using nasolabial flaps to reconstruct oral cavity defects in groups I and II. Results: The size of the nasolabial flaps: width 2.7±0.25cm, length 5.8±0.3cm, thickness 1±0.1cm, pedicle: facial artery and vein(32/32), pedicle length: 13.5±0.4cm. Oral cavity defects (according to LIU): Group I (13/32), Group II (19/32), no discontinuity of mandible. Postoperatively, all flaps survived, and the donor sites healed well. After 3 months, the recipient sites healed, oral cavity functions were normal, and the donor sites healed well. Complications: 7/32 cases had grade III-IV mandibular branch nerve paralysis, recovering after 6 – 8 months; 5 cases had grade III facial paralysis and 2 cases had grade IV facial paralysis. Conclusions: The nasolabial flap, with its long vascular pedicle, is fairly stable and has a high survival rate, making it a good option for reconstructing medium-sized defects in the oral cavity.