Yamawaki Satoko, Sawabe Kazuma, Kataoka Kazuya, Tanaka Shinzo, Suzuki Shigehiko
Department of Plastic and Reconstructive Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Ann Plast Surg. 2011 Mar;66(3):257-60. doi: 10.1097/SAP.0b013e3181d59f7d.
In hypopharyngeal carcinoma, even partial laryngopharyngectomy, results in functional disorders involving swallowing and speaking. We reconstructed partial defects following partial laryngopharyngectomy using a combined flap of a hyoid bone flap and radial forearm free flap. Before ablative surgery, we prepared an ipsilateral hyoid bone as a bone flap with sternohyoidal muscle. Then a radial forearm free flap was prepared simultaneously with tumor surgery. Thereafter, we reconstructed the epiglottis and pyriform recess using the combined flap. We successfully reconstructed 7 patients suffering from squamous cell carcinoma of the hypopharynx. The tracheostoma in all patients could be closed. Six patients could swallow without dysphagia within 48 days. This is the first report of the successful combined use of a hyoid bone flap and radial forearm free flap for hypopharyngeal carcinoma.
在下咽癌中,即使是部分喉咽切除术也会导致吞咽和说话功能障碍。我们使用舌骨瓣和桡侧前臂游离皮瓣联合皮瓣修复部分喉咽切除术后的部分缺损。在切除手术前,我们将同侧舌骨制备成带胸骨舌骨肌的骨瓣。然后在肿瘤手术的同时制备桡侧前臂游离皮瓣。此后,我们使用联合皮瓣重建会厌和梨状窝。我们成功地为7例下咽鳞状细胞癌患者进行了重建。所有患者的气管造口均能关闭。6例患者在48天内能够正常吞咽而无吞咽困难。这是首次成功联合使用舌骨瓣和桡侧前臂游离皮瓣治疗下咽癌的报告。