Department of Speech Pathology and Audiology, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
J Oral Rehabil. 2012 Mar;39(3):170-81. doi: 10.1111/j.1365-2842.2011.02253.x. Epub 2011 Sep 16.
Primary treatment of oropharyngeal cancer often involves surgical resection and reconstruction of the affected area. However, during base of tongue reconstruction the lingual nerve is often severed on one or both sides, affecting sensation in the preserved tissue of the anterior tongue. The loss of specific tongue sensations could negatively affect a person's oral function and quality of life. The aim of this study was to explore the effects of different types of lingual nerve intervention on sensory function for patients with base of tongue cancer as compared to healthy, age-matched adults. Subjects included 30 patients who had undergone primary oropharyngeal reconstruction with a radial forearm free-flap and 30 matched controls. Sensations tested were temperature, two-point discrimination, light touch, taste, oral stereognosis and texture on the anterior two-thirds of the tongue. Results indicated that type of surgical nerve repair may not have a significant impact on overall sensory outcomes, providing mixed results for either nerve repair technique. Sensations for the nonoperated tongue side and operated side with lingual nerve intact were comparable to matched controls, with mixed outcomes for nerve repair. The poorest sensory outcomes were observed in patients with the lingual nerve severed, while all patients with lingual nerve intervention exhibited deteriorated taste sensation on the affected tongue side. Overall, patients in this study who had undergone oropharyngeal reconstruction with lingual nerve intervention exhibited decreased levels of sensation on the operated tongue side, with minimal differences between types of lingual nerve repair.
口咽癌的主要治疗方法通常包括手术切除和受影响区域的重建。然而，在舌根重建过程中，舌神经通常会在一侧或两侧被切断，从而影响到前舌保留组织的感觉。特定舌感觉的丧失可能会对人的口腔功能和生活质量产生负面影响。本研究旨在探讨与年龄匹配的健康成年人相比，不同类型的舌神经干预对口咽癌患者舌根重建后感觉功能的影响。研究对象包括 30 名接受游离前臂皮瓣原发性口咽重建的患者和 30 名匹配对照者。测试的感觉包括温度觉、两点辨别觉、轻触觉、味觉、口腔实体觉和前 2/3 舌的质地觉。结果表明，手术神经修复类型可能不会对整体感觉结果产生显著影响，两种神经修复技术的结果都不一致。未手术侧舌和舌神经完整的手术侧舌的感觉与匹配对照者相似，神经修复的结果则不一致。在舌神经切断的患者中观察到最差的感觉结果，而所有接受舌神经干预的患者在受影响的舌侧均表现出味觉恶化。总的来说，本研究中接受舌神经干预的口咽重建患者在手术侧舌上的感觉水平下降，舌神经修复类型之间的差异最小。
