Suriano Maria, Ferlito Alfio, Benfari Guido, Mascelli Alberto, Cola Claudio, Calabrese Vincenzo
From the Department of Otolaryngology Head and Neck Surgery (m.s., c.c., v.c.), Ospedale Infermi, Rimini, Italy; Department of Surgical Sciences (a.f.), ENT Clinic, University of Udine, Udine, Italy; and Department of Otolaryngology Head Neck Surgery (g.b., a.m.), La Sapienza University, Rome, Italy.
Laryngoscope. 2008 Jul 3. doi: 10.1097/MLG.0b013e31817e2c11.
Ahead of Print article withdrawn by publisher:OBJECTIVES/HYPOTHESIS:: The aim of this study was to describe our results in reconstructive surgery after cancer ablation using the less popular infrahyoid myocutaneous flap as an alternative method to free flaps. Infrahyoid muscles are very useful as a neurovascular myofascial flap in plastic reconstructive surgery of the upper aerodigestive tract, particularly in the restoration of the muscular components in small and medium tongue defects. The surgical technique and the postoperative outcomes are described. STUDY DESIGN:: Retrospective study. METHODS:: During the period 2000 to 2006, 32 patients with squamous cell carcinoma of the tongue were surgically treated using a pure infrahyoid myocutaneous neurovascular flap. RESULTS:: The flap was successful in all cases without flap necrosis, fistula or complications in the donor site. Spontaneous epithelization of the flap took about 2 months to complete, with no evidence of scarring and/or shrinkage. After radiation therapy, flap tissues remained sufficiently soft, trophic, and mobile. Ultrasound evaluation of tongue mobility performed at the time of discharging and 3 and 6 months after surgery, showed normal bolus propulsion. Cinefluoroscopy also showed good function of the reconstructed tongue. CONCLUSIONS:: Tongue reconstruction with a microvascular anastomosed flap can improve functional results after cancer resection. However, in our experience using monolateral or bilateral infrahyoid myocutaneous flap is less time consuming and reduces the complication rate and the operation time in both small and large defects. The main advantage of this flap is its voluntary innervation by the ansa cervicalis and the prevention of scarring and atrophy of the neotongue.
目的/假设:本研究的目的是描述我们使用不太常用的舌骨下肌皮瓣作为游离皮瓣的替代方法进行癌症消融后重建手术的结果。舌骨下肌作为神经血管肌筋膜瓣在上消化道整形重建手术中非常有用,特别是在修复中小舌缺损的肌肉成分方面。描述了手术技术和术后结果。研究设计:回顾性研究。方法:在2000年至2006年期间,对32例舌鳞状细胞癌患者采用单纯舌骨下肌皮神经血管瓣进行手术治疗。结果:所有病例皮瓣均成功,未发生皮瓣坏死、瘘管或供区并发症。皮瓣自发上皮化约需2个月完成,无瘢痕形成和/或收缩迹象。放疗后,皮瓣组织保持足够柔软、营养良好且活动自如。出院时以及术后3个月和6个月对舌活动度进行的超声评估显示推注正常。荧光透视检查也显示重建舌功能良好。结论:微血管吻合皮瓣重建舌可改善癌症切除后的功能结果。然而,根据我们的经验,使用单侧或双侧舌骨下肌皮瓣耗时更少,可降低大小缺损的并发症发生率和手术时间。该皮瓣的主要优点是由颈袢进行自主神经支配,可防止新舌瘢痕形成和萎缩。