Gilbert Ralph W, Goldstein David P, Guillemaud Jennifer P, Patel Rajan S, Higgins Kevin M, Enepekides Danny J
Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital-University Health Network, Toronto, Ontario, Canada.
Arch Otolaryngol Head Neck Surg. 2012 May;138(5):484-91. doi: 10.1001/archoto.2012.410.
To present a technique for reconstruction of the vertical partial laryngectomy defect using a vascularized carrier consisting of a temporoparietal free flap, cartilage graft, and buccal mucosal graft; to evaluate the oncologic outcomes with respect to locoregional control and overall survival; and to provide an assessment of patient quality of life and functional outcomes.
Retrospective medical record review and prospective cross-sectional analysis of functional outcomes.
Princess Margaret Hospital-University Health Network and the Odette Cancer Centre-Sunnybrook Health Sciences Centre.
We collected data on patient demographic characteristics, tumor staging, initial treatment, recurrence, management, and follow-up. Prospectively, a cross-sectional study was performed using the European Organization for Research and Treatment of Cancer Quality of Life of Cancer Patients Questionnaire C30 and HN35 module and voice and swallowing results using the Voice Handicap Index and Swallowing Quality of Life index.
Local recurrence-free survival, cause-specific survival, and overall survival.
Forty men met inclusion criteria (median age, 65.0 years). Local recurrence-free survival was 84% at 3 years and 75% at 5 years. Cause-specific survival was 88% at 3 years and 78% at 5 years. Thirty-eight patients were successfully decannulated; all patients tolerated oral intake after the surgical procedure. The C30 and HN35 symptomatic results were comparable with patients with standardized stages I and II head and neck tumors. The Voice Handicap Index results were comparable with patients with functional dysphonia. Patients' swallowing was in the normal range.
Patients receiving vertical partial laryngectomy with temporoparietal free flap reconstruction for recurrent glottic carcinoma following radiation treatment failure have high rates of locoregional control. The use of the temporoparietal free flap in this patient population produces high-quality voice results and normal swallowing and has no major effect on quality of life.
介绍一种使用由颞顶游离皮瓣、软骨移植片和颊黏膜移植片组成的带血管载体重建垂直部分喉切除缺损的技术；评估局部区域控制和总生存率方面的肿瘤学结果；并对患者生活质量和功能结果进行评估。
回顾性病历审查和功能结果的前瞻性横断面分析。
玛格丽特公主医院 - 大学健康网络和奥德特癌症中心 - 桑尼布鲁克健康科学中心。
我们收集了患者人口统计学特征、肿瘤分期、初始治疗、复发、处理和随访的数据。前瞻性地，使用欧洲癌症研究与治疗组织癌症患者生活质量问卷C30和HN35模块以及使用嗓音障碍指数和吞咽生活质量指数的嗓音和吞咽结果进行横断面研究。
无局部复发生存率、特定病因生存率和总生存率。
40名男性符合纳入标准（中位年龄65.0岁）。3年时无局部复发生存率为84%，5年时为75%。特定病因生存率3年时为88%，5年时为78%。38例患者成功拔管；所有患者术后均能耐受经口进食。C30和HN35症状结果与标准化I期和II期头颈部肿瘤患者相当。嗓音障碍指数结果与功能性发声障碍患者相当。患者吞咽功能在正常范围内。
接受放射治疗失败后复发性声门癌垂直部分喉切除并颞顶游离皮瓣重建的患者局部区域控制率高。在该患者群体中使用颞顶游离皮瓣可产生高质量的嗓音结果和正常吞咽功能，且对生活质量无重大影响。
