Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Otolaryngol Head Neck Surg. 2013 Aug;149(2):232-4. doi: 10.1177/0194599813486882. Epub 2013 Apr 26.
Patients who undergo tongue reconstruction over time may develop gradual worsening of dysarthria and dysphagia secondary to flap atrophy. At our institution, these patients undergo a secondary flap onlay procedure for augmentation of the neotongue. We review a total of 11 patients with total glossectomy defect who underwent secondary tongue augmentation with secondary onlay free flap consisting of radial forearm free flap (n = 6) and rectus free flap (n = 5). There was improvement in swallowing in 7 of 11 patients. Five (45.4%) patients achieved gastric tube independence. Seven (63.6%) patients achieved a varying degree of oral intake. All patients achieved tracheostomy independence. Dysarthria was improved in all patients. There were no flap failures. Therefore, a secondary onlay flap technique is feasible and may improve dysphagia and dysarthria to achieve gastric tube and tracheostomy independence in total glossectomy patients with delayed tongue atrophy.
随着时间的推移，接受舌重建的患者可能会因皮瓣萎缩而逐渐出现构音障碍和吞咽困难。在我们的机构中，这些患者会接受二次皮瓣覆盖术来增加新舌的体积。我们总共回顾了 11 例全舌切除缺损患者，他们接受了二次舌增强术，使用游离桡动脉皮瓣（n=6）和游离腹直肌皮瓣（n=5）进行二次皮瓣覆盖。11 例患者中有 7 例吞咽功能得到改善。5 例（45.4%）患者实现了胃管独立。7 例（63.6%）患者实现了不同程度的经口进食。所有患者实现了气管造口独立。所有患者的构音障碍都得到了改善。没有皮瓣失败的情况。因此，二次皮瓣覆盖技术是可行的，可能会改善全舌切除后因舌萎缩导致的吞咽困难和构音障碍，从而实现胃管和气管造口独立。
