Zhao Yang, Xiang Jing-Zhou, Liu Fa-Yu
Department of Stomatology, Ansteel Group Hospital. Anshan 114008, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2017 Feb;26(1):111-114.
The aim of this study was to evaluate operation-related factors and quality of life (QOL) for patients after tongue reconstruction with radial forearm free flap (RFFF), anterolateral thigh perforator flap (ALT) or submental island flap (SIF).
Totally 59 patients, diagnosed as tongue carcinoma, received glossectomy and simultaneous reconstruction with free flaps including RFFF, ALT or SIF in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, China Medical University from October 2004 to October 2014. All patients were followed up for 6 months and completed the University of Washington Quality of Life scale Version 4 questionnaires. The postoperative QOL was compared among the three groups. The data were analyzed using SPSS 21.0 software package.
The operation duration of SIF group was significantly shorter than those of RFFF group or ALT group (P<0.05). The ALT group had a longer hospitalization time. There were statistically differences among the 3 groups regarding to the size of reconstructed defects. Action QOL score of the ALT group was significantly lower than those of RFFF group and SIF group. There was no significant difference in the total QOL score including chewing, swallowing, speech and postoperative pain among the 3 groups.
In summary, there may be functional disability for patients after glossectomy and simultaneous reconstruction. The quality of life would be acceptable after tongue reconstruction with RFFF, ALT and SIF.
本研究旨在评估采用游离桡侧前臂皮瓣(RFFF)、股前外侧穿支皮瓣(ALT)或颏下岛状皮瓣(SIF)进行舌重建术后患者的手术相关因素及生活质量(QOL)。
2004年10月至2014年10月期间,中国医科大学附属口腔医院口腔颌面外科共有59例被诊断为舌癌的患者接受了舌切除术,并同时采用包括RFFF、ALT或SIF在内的游离皮瓣进行重建。所有患者均接受了6个月的随访,并完成了华盛顿大学生活质量量表第4版问卷。对三组患者术后的生活质量进行比较。数据采用SPSS 21.0软件包进行分析。
SIF组的手术时间明显短于RFFF组或ALT组(P<0.05)。ALT组的住院时间较长。三组在重建缺损大小方面存在统计学差异。ALT组的行动生活质量评分明显低于RFFF组和SIF组。三组在包括咀嚼、吞咽、言语和术后疼痛在内的总生活质量评分方面无显著差异。
总之,舌切除并同期重建术后患者可能存在功能障碍。采用RFFF、ALT和SIF进行舌重建术后生活质量可接受。