Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have simultaneous oral and submandibular defects. Due to its high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by surgeons for oral reconstruction. However, the tissue volume of perforator flaps is insufficient for the reconstruction of both the oral and submandibular regions. In this retrospective cohort study, we compared the postoperative outcomes and complications between patients reconstructed with using the classical ALT perforator flap and patients reconstructed using the chimeric ALT perforator flap with vastus lateralis muscle mass. From August 2017 to August 2019, 25 patients underwent reconstructive therapy using a classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between the two groups. There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4 and 40% in the chimeric and classical group, respectively. The duration of recovery was 12.20 ± 2.69 and 15.67 ± 4.09 days in the chimeric and classical group, respectively. The submandibular region fullness was satisfactory in the chimeric group. The postoperative quality of life in the chimeric group was better than that in the classical group (P < 0.05). The chimerical ALT perforator flap with muscle mass reconstructs both the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and may reduce the incidence of submandibular infection.

中文翻译：

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嵌合性ALT穿孔肌瓣与股外侧肌块在舌癌根治性切除术后口腔和下颌骨缺损重建中的应用：一项回顾性队列研究。

舌癌和舌癌联合根治性切除的舌癌患者通常同时存在口腔和颌下缺损。由于其高度的灵活性，外科医生们正逐渐采用大腿前外侧（ALT）穿孔皮瓣进行口腔重建。但是，穿孔皮瓣的组织体积不足以重建口腔和下颌骨区域。在这项回顾性队列研究中，我们比较了使用经典ALT穿孔皮瓣重建的患者和使用嵌合ALT穿孔皮瓣重建外侧肌量的患者的术后结果和并发症。从2017年8月至2019年8月，有25例患者使用经典ALT穿孔器皮瓣（经典组）进行了重建治疗，中南大学湘雅医院根治性切除舌癌后，用嵌合的ALT穿孔皮瓣（嵌合组）重建26例患者。比较两组的皮瓣成活率，下颌下感染的发生率，外表，下肢功能和生活质量。两组皮瓣成活率和术后下肢功能无差异。嵌合和经典组下颌下感染的发生率分别为15.4和40％。嵌合组和经典组的恢复时间分别为12.20±2.69天和15.67±4.09天。嵌合组下颌下区域充满。嵌合组的术后生活质量优于经典组（P <0.05）。具有肌肉质量的嵌合ALT穿孔皮瓣可准确地重建口腔和下颌骨缺损。它可以保持下颌骨区域的轮廓和丰满度，并可以减少下颌骨感染的发生率。