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老年舌癌患者行舌切除术后应用游离股前外侧穿支皮瓣与游离前臂皮瓣修复的比较

[Comparison of free anterolateral thigh perforator flaps versus free forearm flap for reconstruction in elderly patients undergoing glossectomy].

作者信息

Gao N, Fu K, Lou W H

机构信息

Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

Department of E.N.T., The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2017 Jan 9;52(1):34-38. doi: 10.3760/cma.j.issn.1002-0098.2017.01.007.

Abstract

To evaluate the quality of life (QOL) in elderly patients with tongue cancer who underwent immediate free flap reconstruction surgery. In addition, the efficacy of the anterolateral thigh perforator free flap (ALTFF) and the radial free forearm flap (RFFF) for reconstruction was compared in patients with glossectomy. Ninty-eight patients undergoing complete or partial glossectomy and reconstruction with free flaps were grouped according to flap type. Oral functions were assessed using The University of Washington Quality of Life (UW-QOL), and the 14-item Oral Health Impact Profile questionnaires (OHIP-14) at 6 and 12 months after reconstructive surgery. Eighty-six of 98 questionnaires (88%) were returned. There was significant difference between the 2 groups in the style of resection (0.05). For all oral function domains, the score improved progressively after the operation (6 and 12 months after the procedure). The UW-QOL questionnaire showed a significant difference between the 6 months postoperatively (ALTFF: 290.0 ± 7.8, RFFF: 236.6 ± 24.2) and 12 months postoperatively (ALTFF: 302.0±21.1, RFFF: 331.1±20.4) (<0.05). The OHIP-14 questionnaire showed a total score of ALTFF (422.0± 15.2) which was significantly less than RFFF (434.0±38.7) at 6 months postoperatively (0.05). There were no meaningful differences between the 2 flap types for all oral function domains at 12 months. Using the RFFF or ALTFF for reconstruction of tongue defects after cancer resection influences oral function. There was no significant difference in quality of life between the two flaps at 12 months postoperatively.

摘要

评估接受即刻游离皮瓣重建手术的老年舌癌患者的生活质量(QOL)。此外,比较股前外侧穿支游离皮瓣(ALTFF)和桡侧游离前臂皮瓣(RFFF)在舌癌切除患者重建中的疗效。98例行全舌或部分舌切除并游离皮瓣重建的患者根据皮瓣类型分组。在重建手术后6个月和12个月,使用华盛顿大学生活质量(UW-QOL)和14项口腔健康影响概况问卷(OHIP-14)评估口腔功能。98份问卷中有86份(88%)被收回。两组在切除方式上有显著差异(P=0.05)。对于所有口腔功能领域,术后(术后6个月和12个月)评分逐渐改善。UW-QOL问卷显示术后6个月(ALTFF:290.0±7.8,RFFF:236.6±24.2)和术后12个月(ALTFF:302.0±21.1,RFFF:331.1±20.4)之间有显著差异(P<0.05)。OHIP-14问卷显示术后6个月ALTFF的总分(422.0±15.2)显著低于RFFF(434.0±38.7)(P=0.05)。术后12个月,两种皮瓣类型在所有口腔功能领域均无显著差异。使用RFFF或ALTFF进行癌症切除后舌缺损的重建会影响口腔功能。术后12个月,两种皮瓣的生活质量无显著差异。

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