Joo Young-Hoon, Hwang Se-Hwan, Park Jun-Ook, Cho Kwang-Jae, Kim Min-Sik
Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Auris Nasus Larynx. 2013 Jun;40(3):303-7. doi: 10.1016/j.anl.2012.07.012. Epub 2012 Aug 10.
The purpose of this study was to investigate the relationship between the radial forearm free flap (RFFF) volume changes and speech and swallowing outcomes.
The study included 18 subjects with squamous cell carcinoma of the oral tongue.
Average percentage changes in flap volume between 3 and 12 months was 19.2%. Postoperative free flap volume changes were significantly and negatively correlated with the word and sentence intelligibility (Y=-0.338X+43.641, r(2)=0.383, p=0.006 and Y=-0.246X+34.322, r(2)=0.321, p=0.014, respectively). A significant positive correlation was also found between word and sentence intelligibility and floor of mouth resected, postoperative irradiation. Postoperative flap volume changes between 3 and 12 months were correlated with reduced posterior bolus movement by tongue (p=0.002), reduced tongue base to posterior pharyngeal wall contact (p=0.002), reduced laryngeal elevation (p=0.005), increased aspiration (p=0.005), delayed oral (p=0.010) and pharyngeal transit time (p=0.011). Floor of mouth resected, tongue base resected, and postoperative irradiation also influenced the swallowing outcomes.
This study shows that postoperative flap volume changes are significantly related to speech and swallowing outcomes in patients undergoing partial glossectomy reconstructed with RFFF.
本研究旨在探讨前臂桡侧游离皮瓣(RFFF)体积变化与言语及吞咽结果之间的关系。
该研究纳入了18例口腔舌鳞状细胞癌患者。
皮瓣体积在3至12个月间的平均百分比变化为19.2%。术后游离皮瓣体积变化与单词及句子清晰度显著负相关(分别为Y = -0.338X + 43.641,r² = 0.383,p = 0.006;以及Y = -0.246X + 34.322,r² = 0.321,p = 0.014)。单词及句子清晰度与口底切除、术后放疗之间也存在显著正相关。术后3至12个月皮瓣体积变化与舌推动食团向后运动减少(p = 0.002)、舌根与咽后壁接触减少(p = 0.002)、喉提升减少(p = 0.005)、误吸增加(p = 0.005)、口腔(p = 0.010)及咽运输时间延迟(p = 0.011)相关。口底切除、舌根切除及术后放疗也影响吞咽结果。
本研究表明,对于接受RFFF重建部分舌切除术的患者,术后皮瓣体积变化与言语及吞咽结果显著相关。