文章：

基于面部血管的皮瓣在口腔重建中的应用——叙述性综述

Reconstruction of the Oral Cavity Using Facial Vessel-Based Flaps—A Narrative Review

原文发布日期：2 September 2025

DOI: 10.3390/cancers17172890

类型: Article

开放获取: 是

英文摘要：

Background: Reconstruction of oral cavity defects following oncologic surgery presents both functional and esthetic challenges. While microvascular free flaps remain the gold standard for large defects, local flaps based on facial vessels offer effective solutions for small-to-medium-sized reconstructions. This narrative review evaluates the clinical utility of three commonly used facial vessel-based flaps: facial artery musculomucosal, submental, and nasolabial flaps. Methods: A literature search was conducted using PubMed, targeting studies from 1981 to 2025 that described the anatomical basis, harvesting techniques, modifications, indications, advantages, disadvantages, complications, limitations, and outcomes of these flaps. A total of 73 full-text articles were included based on predefined inclusion criteria. Results: The FAMM flap provides versatile intraoral coverage with low donor site morbidity. The submental flap is effective in select patients, particularly those unfit for microvascular surgery, though its oncologic safety in neck-positive cases is limited. The nasolabial flap offers good esthetic and functional results with minimal external scarring. Each flap presents unique attributes regarding reach, vascularity, and complication profiles. Conclusions: Facial vessel-based flaps are viable and effective options for oral cavity reconstruction in appropriate clinical scenarios. Thorough knowledge of flap anatomy, indications, and oncologic considerations is essential for optimal outcomes.

摘要翻译： 

背景：肿瘤切除术后口腔缺损的重建在功能和美观方面均面临挑战。对于大面积缺损，显微血管游离皮瓣仍是金标准，而基于面部血管的局部皮瓣则为中小型缺损提供了有效的重建方案。本文通过叙述性综述，评估了三种常用面部血管皮瓣的临床应用价值：面动脉肌黏膜瓣、颏下瓣和鼻唇沟瓣。 方法：在PubMed数据库中进行文献检索，纳入1981年至2025年间描述这些皮瓣的解剖基础、切取技术、改良方法、适应症、优缺点、并发症、局限性及临床效果的研究。根据预设的纳入标准，共收录73篇全文文献。 结果：面动脉肌黏膜瓣可为口内缺损提供灵活覆盖，且供区并发症发生率低。颏下瓣适用于特定患者，尤其是不适合显微血管手术者，但其在颈部淋巴结阳性病例中的肿瘤安全性有限。鼻唇沟瓣能实现良好的美学与功能效果，且外部瘢痕最小。每种皮瓣在覆盖范围、血供特点及并发症方面均具有独特属性。 结论：在合适的临床情况下，基于面部血管的皮瓣是口腔缺损重建可行且有效的选择。充分掌握皮瓣解剖、适应症及肿瘤学考量对于获得最佳疗效至关重要。

原文链接：

Reconstruction of the Oral Cavity Using Facial Vessel-Based Flaps—A Narrative Review