Alam Daniel S, Vivek Prashant P, Kmiecik Joann
Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Otolaryngol Head Neck Surg. 2008 Aug;139(2):240-4. doi: 10.1016/j.otohns.2008.03.024.
Laryngectomy with primary closure and tracheoesophageal prosthesis (TEP) voice rehabilitation has been the mainstay of the management of patients with advanced laryngeal malignancy. When adequate mucosal tissue is not available, pharyngeal reconstruction with free flaps can be utilized. The speech outcomes of these patients have been traditionally considered inferior based on the findings of a limited number of studies. We report the results of a review of our experience with radial forearm free flap (RFFF) reconstruction of extensive laryngopharyngectomy defects vs our institutional outcomes seen with primary closure.
Retrospective review.
All patients treated with laryngectomy procedures with either primary closure (28 patients) or RFFF (20 patients) reconstructions at the Cleveland Clinic from 2002 through 2007 were included. Blinded evaluation with statistical analysis of standard speech outcomes measures (maximal sustained phonation, fluent count) as well as qualitative variables are reported.
Based on our data collection, the two groups are statistically indistinguishable.
These findings support the utility and effectiveness of the RFFF in pharyngeal reconstruction in achieving good voice outcomes.
喉切除术一期缝合加气管食管假体（TEP）语音康复一直是晚期喉恶性肿瘤患者治疗的主要方法。当没有足够的黏膜组织时，可以采用游离皮瓣进行咽重建。根据少数研究的结果，这些患者的语音效果传统上被认为较差。我们报告了对采用桡侧前臂游离皮瓣（RFFF）修复广泛喉咽切除术缺损的经验与我们机构一期缝合的结果进行回顾的结果。
回顾性研究。
纳入2002年至2007年在克利夫兰诊所接受喉切除术，采用一期缝合（28例患者）或RFFF（20例患者）重建的所有患者。报告了对标准语音结果指标（最大持续发声、流利计数）以及定性变量进行的盲法评估和统计分析。
根据我们的数据收集，两组在统计学上无差异。
这些发现支持RFFF在咽重建中实现良好语音效果的实用性和有效性。
