Hara I, Gellrich N-C, Düker J, Schön R, Nilius M, Fakler O, Schmelzeisen R, Ozeki S, Honda T
Department of Oral and Maxillofacial Surgery, College of Dentistry, Fukuoka Dental College, Fukuoka, Japan.
Int J Oral Maxillofac Surg. 2003 Dec;32(6):593-9. doi: 10.1054/ijom.2002.0436.
This study assessed swallowing function after tumour resection and reconstruction utilizing free vascularized flap closures in patients with oral cancer. Swallowing function was evaluated postoperatively in 23 patients (21 men and 2 women) who had undergone reconstruction with either a lateral upper arm free flap (LUFF, n=16) or a radial forearm free flap (RFFF, n=7). Videofluoroscopy was used to assess tongue mobility and abnormalities of swallowing function. All patients who underwent reconstruction with LUFF or RFFF free flaps had decreased tongue mobility, except for the tip of the tongue. Patients who underwent anterior or posterior resection had greater decreases in tongue mobility than those who underwent medial resection. Swallowing impairment was similar in patients with LUFFs and those with RFFFs. Anterior resection of the oral cavity had a significant negative effect on swallowing function. Silent aspiration occurred in five patients. In conclusion the resection site affected swallowing function, but the type of flap did not, in patients with oral carcinoma, who underwent tumour resection with reconstruction
本研究评估了口腔癌患者在肿瘤切除及采用游离血管化皮瓣封闭进行重建术后的吞咽功能。对23例患者（21例男性和2例女性）进行了术后吞咽功能评估，这些患者接受了外侧上臂游离皮瓣（LUFF，n = 16）或桡侧前臂游离皮瓣（RFFF，n = 7）重建术。采用视频荧光吞咽造影评估舌运动功能及吞咽功能异常情况。所有接受LUFF或RFFF游离皮瓣重建术的患者，除舌尖外，舌运动功能均下降。接受前部或后部切除的患者比接受中部切除的患者舌运动功能下降更明显。LUFF患者和RFFF患者的吞咽障碍情况相似。口腔前部切除对吞咽功能有显著负面影响。5例患者发生隐匿性误吸。总之，在接受肿瘤切除及重建术的口腔癌患者中，切除部位影响吞咽功能，但皮瓣类型不影响。
