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部分舌切除术后的语音:重建与未重建患者的比较

Speech after partial glossectomy: a comparison between reconstruction and nonreconstruction patients.

作者信息

Chuanjun Chen, Zhiyuan Zhang, Shaopu Gao, Xinquan Jiang, Zhihong Zhang

机构信息

Department of Oral Maxillofacial Surgery, The 9th Affiliated Hospital, Shanghai Second Medical University, Shanghai, China.

出版信息

J Oral Maxillofac Surg. 2002 Apr;60(4):404-7. doi: 10.1053/joms.2002.31228.

Abstract

PURPOSE

This study was undertaken to compare the articulation intelligibility of patients after hemiglossectomy or minor glossectomy within the hemitongue with or without reconstruction.

MATERIALS AND METHODS

The articulation intelligibility of 19 patients who underwent hemiglossetomy or minor glossectomy within the hemitongue was investigated at least 6 months after surgery with an articulation intelligibility test with 40 sensitive Chinese sounds. Patients were divided into group 1 (those undergoing reconstructive surgery after glossectomy) and group 2 (those not undergoing reconstructive surgery after glossectomy). Defects of the tongue (in group 1) were reconstructed immediately with free radial forearm flaps or pedicled flaps after glossectomy and closed primarily without reconstruction in group 2. The articulation intelligibility scores were compared between the 2 groups.

RESULTS

The mean articulation intelligibility score for group 1 was 77.0% (blade portion glossal sounds), 76.3% (mid portion glossal sounds), and 84.7% (rear portion glossal sounds), and those of group 2 were 94.6%, 92.1%, and 95.3%, respectively. The intelligibility of articulation of group 2 was significantly higher than that of group 1 in blade portion glossal sounds (P <.05), mid portion glossal sounds (P <.05), and rear portion glossal sounds (P <.01).

CONCLUSION

The articulation intelligibility was better in patients not receiving grafts than in those receiving grafts. Reconstruction with flaps, which may interfere with the flexibility and mobility of the tongue, may contribute to articulatory impairment. If speech is the outcome of interest, reconstruction may be unnecessary with hemiglossectomy or other partial (minor) glossectomy within the hemitongue.

摘要

目的

本研究旨在比较半舌切除术或半舌内小舌切除术患者在有或无重建情况下的发音清晰度。

材料与方法

对19例行半舌切除术或半舌内小舌切除术的患者在术后至少6个月进行发音清晰度测试,测试包含40个敏感的汉语语音。患者被分为1组(舌切除术后接受重建手术者)和2组(舌切除术后未接受重建手术者)。1组舌部缺损在舌切除术后立即用游离桡侧前臂皮瓣或带蒂皮瓣进行重建,2组则直接缝合不进行重建。比较两组的发音清晰度评分。

结果

1组的平均发音清晰度评分在舌叶音为77.0%,舌中音为76.3%,舌后音为84.7%;2组分别为94.6%、92.1%和95.3%。2组在舌叶音(P <.05)、舌中音(P <.05)和舌后音(P <.01)方面的发音清晰度明显高于1组。

结论

未接受移植的患者发音清晰度优于接受移植的患者。皮瓣重建可能会干扰舌头的灵活性和运动性,从而导致发音障碍。如果关注的结果是言语功能,那么对于半舌切除术或半舌内其他部分(小)舌切除术,可能无需进行重建。

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