Neuroncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Neurol Sci. 2019 Mar;40(3):553-559. doi: 10.1007/s10072-018-3687-5. Epub 2019 Jan 2.
Total or nearly glossectomy with laryngeal preservation may lead to development of dysfunction speech, chewing, and swallowing with orally disabled. Pellini et al. analyze the feasibility of vastus lateralis myofascial free flap (VLMFF) in tongue reconstruction and demonstrated that this treatment offers a better cosmetic result in tongue reconstruction, an adequate bulk when needed, a mass reduction of neo-tongue after 30 days post-surgery of 20-30%, an optimal functional results, and an obliteration of dead space and with thus preventing fistulas and infections with minimal morbidity. The aim of our study was to evaluate the innervation of tongue reconstruction performed with nerve anastomosis between the unilateral hypoglossal nerve and branch for vastus lateralis muscle of femoral nerve with neurophysiological study.
We performed a neurophysiological evaluation of four patients who underwent surgery and observed a reinnervation of tongue flap by the anastomosis hypoglossal-femoral nerve for the reconstruction of neo-tongue with vastus lateralis myofascial free flap. The reconstruction of neo-tongue with vastus lateralis myofascial free flap may be represent a valid surgery for patients with cancer tongue.
全舌或近全舌切除并保留喉可能导致言语、咀嚼和吞咽功能障碍，使患者口腔功能受损。Pellini 等人分析了股外侧肌肌筋膜游离皮瓣（VLMFF）在舌重建中的可行性，结果表明该治疗方法在舌重建中提供了更好的美容效果，在需要时提供足够的体积，术后 30 天新舌的质量减少 20-30%，功能结果理想，并且能够消灭死腔，从而最大限度地减少并发症（瘘管和感染），发病率低。我们的研究目的是通过对单侧舌下神经与股神经股外侧肌支吻合进行神经吻合的舌重建进行神经生理学研究，来评估舌重建的神经支配。
我们对 4 例接受手术的患者进行了神经生理学评估，观察到吻合舌下神经-股神经对股外侧肌肌筋膜游离皮瓣重建新舌的舌瓣进行了再神经支配。对于舌癌患者，股外侧肌肌筋膜游离皮瓣重建新舌可能是一种有效的手术方法。
