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[口咽癌患者软腭重建后的功能结果]

[Functional results after soft palate reconstruction in oropharyngeal cancer patients].

作者信息

Herzog M, Grafmans D, Plontke S K, Bartel S, Plößl S

机构信息

Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Deutschland.

Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.

出版信息

HNO. 2021 Feb;69(2):122-130. doi: 10.1007/s00106-020-00839-8.

Abstract

BACKGROUND

Surgery of the soft palate in patients with oropharyngeal cancer can result in functional deficiencies of swallowing and speech. Reconstruction of the resected structures can contribute to regaining sufficient functionality after therapy.

OBJECTIVE

The current study used frequency analysis to evaluate the change in speech characteristics after resection and reconstruction of the soft palate during post-therapeutic follow-up.

MATERIALS AND METHODS

In 18 patients with oropharyngeal carcinoma and involvement of the soft palate, resection and reconstruction by free radial forearm graft (FRFG) and adjuvant chemoradiotherapy was conducted. The spoken German numbers "eins", "zwei", "drei", "vier", "fünf" were recorded during follow-up and objectively assessed by frequency analysis. Additionally, food intake status and the necessity of a tracheostomy were evaluated.

RESULTS

The maximum peak frequencies of the numbers analysed increased from 150-300 Hz before up to 1000 Hz after therapy. Two years post therapy, the peak frequencies again declined to levels comparable to those before tumour therapy. One year after therapy, complete oral nutrition was possible in two thirds of patients and the tracheostomy was closed in 80%.

CONCLUSION

Reconstruction of the soft palate by FRFG during the course of oropharyngeal cancer treatment allows function to be regained with respect to speech and swallowing. In the majority of patients, it is possible to reach a level of function comparable to the state before tumour treatment.

摘要

背景

口咽癌患者的软腭手术可导致吞咽和言语功能缺陷。重建切除结构有助于治疗后恢复足够的功能。

目的

本研究采用频率分析评估软腭切除重建后治疗随访期间言语特征的变化。

材料与方法

对18例口咽癌累及软腭的患者进行了游离桡侧前臂皮瓣(FRFG)切除重建及辅助放化疗。随访期间记录德语口语数字“eins”“zwei”“drei”“vier”“fünf”,并通过频率分析进行客观评估。此外,评估食物摄入状况和气管切开的必要性。

结果

分析数字的最大峰值频率从治疗前的150 - 300赫兹增加到治疗后的1000赫兹。治疗后两年,峰值频率再次下降至与肿瘤治疗前相当的水平。治疗后一年,三分之二的患者能够完全经口营养,80%的患者气管切开已闭合。

结论

在口咽癌治疗过程中采用FRFG重建软腭可恢复言语和吞咽功能。在大多数患者中,可达到与肿瘤治疗前相当的功能水平。

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