小～中規模下歯肉頬移行部複合欠損に対する舌骨筋リリースを伴う一次閉鎖の長期機能予後：皮弁に代わる選択肢

Surgery for early-stage lower gingiva-buccal sulcus (GBS) complex lesions results in small to medium size defects. There are a variety of techniques for reconstruction; however, primary closure with hyoglossus release provides a primary mucosal cover while maximally preserving form and function. This study aims to assess long-term results of hyoglossal release method of reconstruction.

This is a longitudinal prospective study of oral squamous cell carcinoma of lower GBS complex lesions who underwent resection with primary closure with hyoglossus release. All demographic, clinical, surgical resection, flap viability and flap complication data were collected and recorded prospectively. On follow-up, all patients underwent functional outcome and form assessment including speech and swallowing assessment, mouth opening, tongue range of motion and cheek distortion.

Thirty-six patients underwent primary closure with hyoglossus release after lower GBS composite resection. Marginal mandibulectomy was done in 80.6% (n = 29) and segmental mandibulectomy in 19.4% (n = 7). On functional assessment, 77.8% (n = 28) had normal functional swallow, 69.4% (n = 25) had normal tongue protusion while the mouth opening was more than 3.5 cm in 41.7% (n = 15).

Primary closure by hyoglossus release is well suited for anterior, lateral and posterior lower GBS complex defects with maximal preservation of form and function. The technique is simple, intuitive and is an useful alternative to local, pedicled or free flaps.