舌及口底恶性肿瘤切除后缺损的修复

Reconstruction of Tongue and Floor of Mouth after Tumor Resection

目的:探讨修复技术在舌及口底肿瘤手术治疗中的应用。方法:分析13例舌及口底癌患者,接受舌部分或全切后应用3种皮瓣进行舌及口底缺损的1期修复。皮瓣包括胸大肌肌皮瓣(PMMC)9例,游离腹直肌肌皮瓣(RAM)3例,游离肩胛皮瓣1例。结果:除1例患者因下咽癌曾行全喉、下咽及食道切除外,其余患者均在切除病变的基础上保存了喉,术后均能发音并可经口进食无误吸,无皮瓣坏死等并发症。结论:修复技术应用于进展期舌及口底癌的治疗,提高了治疗效果及生存质量。

Objective: To study the reconstruction of tongue and floor of mouth after tumor resection. Methods: Thirteen patients with carcinoma in tongue and floor of mouth (male 9, female 4) were reviewed. According to the defect of tongue and floor of mouth, the reconstruction was accomplished respectively with 3 different flaps after partial or total glossectomy. Pedicle pectoralis major musculocutaneous flap (PMMC) was applied in 9 cases, rectus abdominis myocutaneous free flap (RAM) in 3 and scapular free flap in 1. Results: With the exception of one patient who had undergone total pharyngolaryngectomy because of hypopharyngeal carcinoma before, all of the patients underwent partial or total tongue resection with preservation of larynx. The postoperative course was uneventful in all patients. There were no flap necroses. All the patients could speak clearly and achieved an oral intake. Conclusion: After the resection of carcinoma of tongue and floor of the mouth in the first stage, the reconstruction with flap will get a good functional result.