基于皮瓣厚度精确重建次全舌缺损的效果评价

Evaluation of Accurate Reconstruction of Subtotal Tongue Defect Based on Flap Thickness

目的:基于皮瓣厚度精确重建次全舌,并进行临床疗效评价。方法:收集笔者科室2017年6月-2020年9月行次全舌重建患者资料进行分析,共9例晚期舌鳞癌患者,均采用股前外侧皮瓣进行次全舌重建。依据测量结果估算重建舌体积平均约120 cm^(3),将重建舌体积分为小于120 cm^(3)的A组和大于120 cm^(3)的B组。其中A组患者5例,B组患者4例,采用Likert量表评估次全舌重建患者的吞咽功能、语言清晰度和美观度。结果:9例患者皮瓣均愈合良好。与A组比较,B组患者术后吞咽功能(P=0.028)显著改善,语言清晰度(P=0.273)及美观度(P=0.107)无显著差异。结论:基于皮瓣厚度精确重建全舌体积,可能获得更佳的临床效果,值得临床推广。

Objective To accurately reconstruct the whole tongue based on the thickness of flap and evaluate the clinical effect.Methods The data of patients who underwent subtotal tongue reconstruction in our department from June 2017 to September 2020 were collected and analyzed.A total of 9 patients with advanced tongue squamous cell carcinoma underwent subtotal tongue reconstruction with anterolateral femoral flap.According to the measurement results,the average reconstructed tongue volume was estimated to be about 120 cm^(3).The reconstructed tongue body was integrated into group a less than 120 cm^(3)and group B greater than 120 cm^(3).There were 5 patients in group A and 4 patients in group B.Likert scale was used to evaluate the swallowing function,language clarity and aesthetics of patients with subtotal tongue reconstruction.Results The flaps of 9patients healed well.Compared with group A,the swallowing function(P=0.028)in group B was significantly improved,and there was no significant difference in language clarity(P=0.273)and aesthetics(P=0.107).Conclusion Accurate reconstruction of total tongue volume based on flap thickness may obtain better clinical effect and is worthy of clinical promotion.