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半舌切除术后接受前臂桡侧皮瓣移植患者的功能评估

Functional Assessments in Patients Undergoing Radial Forearm Flap Following Hemiglossectomy.

作者信息

Li Xiangru, Sun Qiang, Guo Shu

机构信息

*Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou †Department of Plastic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.

出版信息

J Craniofac Surg. 2016 Mar;27(2):e172-5. doi: 10.1097/SCS.0000000000002261.

Abstract

Our goal was to evaluate the functional outcomes following radial forearm free-flap reconstruction with a focus on radiotherapy. A 2-year prospective study was performed. A total of 47 patients were enrolled finally. They were asked to complete the swallowing, chewing, speech domains of the University of Washington Quality of Life questionnaire preoperatively and at 2 years postoperatively. Swallowing capacity was apparently affected after surgery, but no patients reported there was chokes cough during eating, the mean score was 51.1 (SD: 21.3). Most patients (70.2%) presented their articulation was good enough for everyday life, and the mean score was 60.0 (SD: 21.1). As for chewing, only 7 (14.9%) patients complained there was negative effect, and the mean score was as high as 92.6 (SD: 18.0). Compared to patients with surgery only, patients with postoperative radiotherapy only had significantly worse swallowing and speech capacity. Compared with patients with postoperative radiotherapy only, patients with both preoperative and postoperative radiotherapy tended to have better swallowing and speech. No significant differences were found between chewing and radiotherapy. In most patients, the results of swallowing, speech, and chewing are favorable. Postoperative radiotherapy has an apparent impact on functional impairment, but preoperative tends to preserve the original tongue function.

摘要

我们的目标是评估前臂桡侧游离皮瓣重建术后的功能结果,重点关注放射治疗。进行了一项为期2年的前瞻性研究。最终共纳入47例患者。要求他们在术前和术后2年完成华盛顿大学生活质量问卷中的吞咽、咀嚼、言语领域的调查。术后吞咽能力明显受到影响,但没有患者报告进食时有呛咳,平均得分为51.1(标准差:21.3)。大多数患者(70.2%)表示其发音足以满足日常生活需要,平均得分为60.0(标准差:21.1)。至于咀嚼,只有7例(14.9%)患者抱怨有负面影响,平均得分高达92.6(标准差:18.0)。与仅接受手术的患者相比,仅接受术后放疗的患者吞咽和言语能力明显更差。与仅接受术后放疗的患者相比,术前和术后均接受放疗的患者吞咽和言语功能往往更好。咀嚼和放疗之间未发现显著差异。在大多数患者中,吞咽、言语和咀嚼的结果良好。术后放疗对功能损害有明显影响,但术前放疗往往能保留原有的舌功能。

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