股前外侧皮瓣修复中晚期舌癌术后缺损

Tongue reconstruction with anterolateral thigh flap for middle-late stage tongue cancer patients

目的报道应用股前外侧皮瓣移植修复中晚期舌癌术后缺损的临床效果。方法对9例中晚期舌癌患者接受舌癌联合根治术同期应用吻合血管的股前外侧皮瓣移植修复术后缺损。皮瓣切取面积最大10cm×12cm，最小7cm×10cm，修复舌及1：3底缺损。术后随访评价再造舌形态、活动度、吞咽功能及语音功能。结果9例患者供区均直接拉拢缝合，术后供受区伤口期愈合，股前外侧皮瓣成活。术后平均随访18个月，肿瘤无复发，无严重并发症，再造舌外形较丰满，有一定的活动度，吞咽、语音功能恢复良好，供区瘢痕隐蔽，临床疗效满意。结论股前外侧皮瓣移植修复中晚期舌癌术后缺损的临床效果满意，值得推广应用。

Objective To investigate the outcome of microvascular reconstruction of the tongue with anterolateral thigh flaps in the treatment of middle-late stage tongue cancer patients. Methods From December 2003 to March 2007, nine patients underwent simultaneous reconstruction of the tongue and oral floor defects with anterolateral thigh flaps after resection of squamous cell carcinoma of tongue. The flaps ranged from 7 cm × 10 cm to 10 cm × 12 cm in size, and were adjusted to the defect of the tongue and oral floor. The vascular pedicle included descending branch of the lateral femoral circumflex artery and the accompanying veins. The outcome of reconstruction was evaluated by follow-up examinations,considering the contour and mobility of the reconstructed tongues, the swallowing function and the speech function. Results All of the donor sites were closed directly,with minimal donor-site morbidity. All patients recovered uneventfully from surgery ,with no immediate postoperative complications：no flap necrosis, no wound infection or wound dehiscence. The transplanted flaps survived well. The average follow-up period was 18 months. During the follow-up period there was no tumor recurrence and the contour of the reconstructed tongues showed suffi- cient bulk. The patients demonstrated good mobility of the reconstructed tongue. The swallowing and speech function recovered satisfactory. Two months postoperatively the patients were able to ingest a solid or semisolid diet, and six months postoperatively the patients developed intelligibe language. Conclusion The anterolateral thigh flaps are suitable and reliable for the microsurgical reconstruction of the large defects caused by middle-late stage tongue cancer.