Thankappan Krishnakumar, Kuriakose Moni A, Chatni Shilpa S, Sharan Rajeev, Trivedi Nirav P, Vijayaraghavan Sundeep, Sharma Mohit, Iyer Subramania
Head and Neck Institute, and Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Ann Plast Surg. 2011 Mar;66(3):261-6. doi: 10.1097/SAP.0b013e3181d50e9e.
The purpose of this study was to report the effectiveness of the lateral arm free flap (LAFF) in the reconstruction of oral tongue defects, the subsite in which it may have advantage over the other donor sites. This is a retrospective analysis of 48 consecutive cases of LAFF used for the reconstruction of partial glossectomy defects for squamous cell carcinoma of the oral tongue. Primary defect and donor-site morbidity and the functional and aesthetic outcomes were assessed in 37 evaluable patients, with a minimum of 6 months follow-up. Patient-reported Visual Analog Scale score from 0 (minimum satisfaction) to 10 (maximum satisfaction) was used to evaluate the aesthetic outcome. The follow-up was for 6 to 52 months (mean, 24 months). The flap was successful in 45 (93.8%) patients. The commonest observed donor-site morbidity was a broad scar, but it did not cause much patient dissatisfaction because it could be covered with appropriate dressing. Speech was normal or near-normal in all patients. Poor functional outcome was associated with adjuvant postoperative radiotherapy. The visual analog scale score for the aesthetic satisfaction (mean [standard deviation]) was 6.58 (1.82) for primary site and 7.13 (1.99) for the donor site. LAFF is an excellent option for the reconstruction of partial glossectomy defects of oral tongue without significant involvement of the floor of mouth and base of tongue.
本研究的目的是报告上臂外侧游离皮瓣（LAFF）在口腔舌部缺损重建中的有效性，以及该供区相较于其他供区可能具有优势的亚部位。这是一项对48例连续使用LAFF重建口腔舌鳞状细胞癌部分舌切除术缺损病例的回顾性分析。对37例可评估患者评估了原发缺损、供区并发症以及功能和美学效果，随访时间至少6个月。采用患者报告的视觉模拟量表评分（从0分[最低满意度]到10分[最高满意度]）来评估美学效果。随访时间为6至52个月（平均24个月）。45例（93.8%）患者皮瓣成功。观察到的最常见供区并发症是较宽的瘢痕，但由于可用合适敷料覆盖，未引起患者太多不满。所有患者语音正常或接近正常。功能结果较差与术后辅助放疗有关。原发部位美学满意度的视觉模拟量表评分（均值[标准差]）为6.58（1.82），供区为7.13（1.99）。对于口腔舌部部分舌切除术缺损的重建，在口底和舌根无明显受累的情况下，LAFF是一个极佳的选择。
