舌瓣修复咽喉术后缺损的临床研究

The clinical study of tongue flaps repairing after resecting pharyngeal neoplasm and laryngeal neoplasm

目的 探讨咽喉肿瘤切除后咽喉组织缺损的舌瓣修复方法。方法 设计了 1 3舌体舌瓣、半侧舌根舌瓣、全舌根舌瓣、横行舌根舌瓣等 4种舌瓣 ,对 15例口咽侧壁癌、下咽癌、声门上型癌切除后的组织缺损进行了修复。结果 15例患者舌瓣全部成活 ,13例颈部伤口Ⅰ期愈合 ,2例颈部伤口感染裂开 ,经处理愈合 ,进食良好。 1、3年生存率分别为 92 .9% ( 13 14)、72 .7% ( 8 11)。结论 舌瓣修复咽喉组织缺损 ,具有操作方便、血供丰富、成活率高、并发症少等优点 ,值得临床推广应用。

Objective To study the repair methods of the defect after resecting pharyngeal neoplasm and laryngeal neoplasm. Methods Four kinds of tongue flap, such as 1/3 tongue flap, 1/2 tongue base flap, tongue base flap and transverse tongue flap were devised and appliel in 15 patients with pharyngeal neoplasm and laryngeal neoplasm. Results These tongue flaps were alive in all patients. The wound of 13 patients healed in Ⅰ stage. Two patients dehiscenced because of infection and healed after treatment. All the patients deglutited well. Oneyear,3year, diseasefree survive rate were 92.9%(13/14),72.7%(8/11)respectively. Conclusion Tongue flaps are obtained easily, with enough blood flow, adapted to pharyngeal environment, easily alive and low complication in repairing the pharyngeal defect. We think that these tongue flaps should be applied in clinic.