Hara I, Gellrich N-C, Duker J, Schön R, Fakler O, Smelzeisen R, Honda T, Satoru O
Department of Oral and Maxillofacial Surgery, College of Dentistry, Fukuoka Dental College, Fukuoka, Japan.
Br J Oral Maxillofac Surg. 2003 Jun;41(3):161-9. doi: 10.1016/s0266-4356(03)00068-8.
Swallowing, speech, and morbidity were assessed postoperatively in 25 patients, 18 of whom had had intraoral defects reconstructed by lateral upper arm free flaps (LUFF) and 7 by radial forearm free flaps (RFFF). Video fluoroscopy was used to assess swallowing, the Freiburger audiometric test to assess speech; and measurement of arm circumference to assess donor site morbidity. A questionnaire was used to evaluate swallowing, speech, and donor site morbidity subjectively. The degree of impairment in swallowing depended on the site of resection. Anterior and posterior resections affected swallowing more than lateral resections. Anterior resection and the use of LUFFs reduced intelligibility. There was no significant difference in impairment between LUFF and RFFF. We conclude that the LUFFs are superior to RFFFs because they can be closed primary and the incidence of donor site morbidity is slight.
对25例患者术后的吞咽、言语及并发症情况进行了评估，其中18例患者采用上臂外侧游离皮瓣（LUFF）修复口腔内缺损，7例采用桡侧前臂游离皮瓣（RFFF）修复。采用电视荧光吞咽造影评估吞咽功能，使用弗赖堡听力测试评估言语功能；通过测量上臂围评估供区并发症情况。采用问卷调查主观评估吞咽、言语及供区并发症情况。吞咽功能受损程度取决于切除部位。前部和后部切除对吞咽功能的影响大于外侧切除。前部切除及使用LUFF会降低言语清晰度。LUFF和RFFF在功能受损方面无显著差异。我们得出结论，LUFF优于RFFF，因为其可以一期缝合，且供区并发症发生率较低。
