薄型股前外侧皮瓣与前臂皮瓣修复舌体缺损的对比性研究

Comparative study in reconstruction of tongue defect with thin anterolateral flap and forearm flap

目的 探讨薄型股前外侧皮瓣在舌癌术后缺损修复中的应用价值.方法 回顾分析2009年12月至2011年12月应用游离薄型殷前外侧皮瓣及游离前臂皮瓣修复46例舌癌术后半舌缺损,并对比2种修复方法术后血管危象发生率、舌体外形恢复满意程度、语言及吞咽功能恢复状况等.结果 46例舌癌患者采取了薄型股前外侧皮瓣或前臂皮瓣修复,其中12例薄型股前外侧皮瓣全部成活,1例发生血管危像,经抢救后皮瓣成活;34例前臂皮瓣中33例成活,3例发生血管危像,抢救后2例皮瓣成活,1例发生坏死.对比2种舌癌手术修复方法表明：2种方法术后舌体外形基本满意,口腔功能基本恢复,语言及吞咽功能亦无明显差别.结论 薄型股前外侧皮瓣修复舌癌术后舌体缺损效果佳、外形好,功能恢复与前臂皮瓣修复效果无明显区别,且对供区影响小,组织量丰富、供区隐蔽,可以作为修复舌癌术后缺损的首选方法.

Objective To compare the thin anterolateral flap with forearm flap in tongue defect repairing, and to introduce our methods and experiences in the tongue reconstruction with the thin anterolateral flap. Methods The clinicopathologic data of 46 cases with tongue carcinoma were obtained from School of Stomatology, Nanjing University Medical Center, Nanjing University from December 2009 to December 2011. To compare two methods of incidence of vascular crisis, tongue shape, language and swallowing functional recovery. Results 46 patients with tongue carcinoma were performed the tongue reconstruction in 12 month, which 12 cases were used the thin anterolateral flap and 34 cases were used the forearm flap. In the thin anterolateral flap group, All cases were succeeded. 1 case occurs vascular crisis. In the forearm flap group, 33 cases were succeeded, and 1 case occurs necrosis. 3 cases occurs vascular crisis. The results of comparing two methods showed that： no obvious differences in the tongue shape, and no obvious differences in the function of language and swallowing. Conclusions There no obvious differences in the reconstruction of tongue defect between the thin anterolateral flap and the forearm flap. The thin anterolateral flap have some advantages： little influence is on the donor site, the flap extent is abundant, the donor site is not spectacular. The thin anterolateral flap should be piror method for the tongue defect repairing.