Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Hallym University Medical Center, Republic of Korea.
Oral Oncol. 2011 Oct;47(10):988-92. doi: 10.1016/j.oraloncology.2011.07.022. Epub 2011 Aug 16.
For advanced stage tonsil cancer, extensive resection of the soft palate is unavoidable. The purpose of this study is to report on the speech outcome according to the various types of defects and reconstruction techniques. This prospective study was performed on 53 patients of tonsil cancer. The postoperative speech function was evaluated for three factors: nasalance, speech intelligibility, and velopharyngeal insufficiency. Four reconstruction methods used for the soft palate defect: local flap, patch method, Gehanno method, and Denude method. Univariate analysis showed that the Denuded reconstruction technique, more than one-half of the soft palate resection, and T stage was significantly associated for nasalance, speech intelligibility, and velopharyngeal insufficiency. Multivariate analysis showed that the Denuded reconstruction technique (for patients with extensive soft palate and posterior pharyngeal wall defect) was the most significant variable. When the defect of tonsil cancer is extensive, especially when it extends to the posterior pharyngeal wall, a reconstruction method that can reduce the velopharyngeal cross-sectional area efficiently, such as the Gehanno method, is preferred.
对于晚期扁桃体癌，广泛切除软腭是不可避免的。本研究旨在根据各种类型的缺陷和重建技术报告其语音结果。该前瞻性研究共纳入 53 例扁桃体癌患者。对术后的语音功能进行鼻音、言语清晰度和腭咽闭合不全三个因素的评估。用于软腭缺损的四种重建方法：局部皮瓣、修补法、Gehanno 法和裸露法。单因素分析显示，裸露重建技术、软腭切除超过一半以及 T 分期与鼻音、言语清晰度和腭咽闭合不全显著相关。多因素分析显示，裸露重建技术（用于广泛的软腭和后咽壁缺损的患者）是最显著的变量。当扁桃体癌的缺损广泛时，特别是当它延伸到后咽壁时，应选择能够有效降低腭咽横截面积的重建方法，如 Gehanno 法。
