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半舌切除术后桡侧前臂游离皮瓣重建的长期随访研究

Long-term follow-up study of radial forearm free flap reconstruction after hemiglossectomy.

作者信息

Akashi Masaya, Hashikawa Kazunobu, Sakakibara Akiko, Komori Takahide, Terashi Hiroto

机构信息

From the Departments of *Oral, Maxillofacial Surgery and †Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

J Craniofac Surg. 2015 Jan;26(1):44-7. doi: 10.1097/SCS.0000000000001176.

Abstract

Previous studies on postoperative long-term results in patients who underwent reconstructive free flap transfer following hemiglossectomy had some issues, including the heterogeneity of the patient population and the observation period. The present study aimed to evaluate changes of reconstructed tongues in patients who underwent radial forearm free flap (RFFF) after hemiglossectomy with long-term follow-up. We enrolled 23 patients who underwent RFFF after hemiglossectomy with a postoperative follow-up of 5 years or more. Postoperative status (eating, speech, sensation function) was assessed by concise medical inquiries. Morphological changes of flaps were evaluated by reviewing clinical photographs. Hemiglossectomy involving the base of the tongue was performed in 4 cases (17.4%) and was limited to the mobile tongue in 19 cases (82.6%). The mean follow-up was 85.4 months (range, 60-122 months). All patients experienced gradually improved postoperative status. The most significant improvement was found between 1 and 5 years after surgery (P = 0.007), but not between 1 and 3 years (P = 0.075) or between 3 and 5 years (P = 0.530). In almost all of the flaps, there were few morphological changes throughout the follow-up period. Postoperative status in patients who underwent reconstructive RFFF following hemiglossectomy improved sequentially.

摘要

以往关于半舌切除术后接受游离皮瓣重建患者的术后长期结果的研究存在一些问题,包括患者群体的异质性和观察期。本研究旨在通过长期随访评估半舌切除术后接受桡侧前臂游离皮瓣(RFFF)患者重建舌的变化。我们纳入了23例半舌切除术后接受RFFF且术后随访5年或更长时间的患者。通过简要的医学询问评估术后状态(进食、言语、感觉功能)。通过回顾临床照片评估皮瓣的形态学变化。4例(17.4%)患者的半舌切除术涉及舌根,19例(82.6%)患者的半舌切除术仅限于活动舌。平均随访时间为85.4个月(范围60 - 122个月)。所有患者术后状态逐渐改善。术后1至5年改善最为显著(P = 0.007),但1至3年(P = 0.075)或3至5年(P = 0.530)改善不明显。在几乎所有皮瓣中,整个随访期间形态学变化很少。半舌切除术后接受重建性RFFF患者的术后状态依次改善。

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