Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Otolaryngology Head and Neck Surgery, Surgical Oncology, University of Sheffield, Doncaster Royal Infirmary, Sheffield, UK.
Acta Otolaryngol. 2020 Dec;140(12):1036-1042. doi: 10.1080/00016489.2020.1804614. Epub 2020 Aug 18.
This study investigated the effects of reconstruction of hypopharyngeal non-circumferential defects with a submental island flap after ablation of hypopharyngeal carcinoma.
The purpose of our study was to identify advantages and limitations of the submental flap for reconstruction of non-circumferential hypopharyngeal defects.
A total of 27 patients who had stage II-IV hypopharyngeal cancer and underwent pharyngeal reconstruction with a submental flap by the senior author in both Department of Otolaryngology Head Neck Surgery, Chinese PLA General Hospital and Department of Otolaryngology Head Neck Surgery, Beijing Friendship Hospital, Capital Medical University.
96.3% (26/27) cases of submental island flap survived. There were two pharyngocutaneous fistulas, one recovered spontaneously, and the other was associated with flap necrosis, underwent neck debridement and flap removal. All except for one patient had decannulation of their nasogastric tube 2 weeks postoperatively. There was no evidence of a stricture or stenosis of the laryngopharynx, nor any sign of aspiration, except for one with esophageal inlet stricture caused by radiotherapy. There were two cases of obvious paraesthesia pharynges due to beard growth at the submental flap after reconstruction. 63.0% (17/27) patients are alive and 37% (10/27) have died of disease. The 3-year survival rate is 56.3% and the 5-year survival rate is 50.0%.
The submental flap reconstruction for moderately sized non-circumferential hypopharyngeal defects is a recommended treatment option.
本研究探讨了下咽癌切除术后应用颏下岛状瓣重建下咽非环形缺损的效果。
本研究旨在确定颏下瓣在重建非环形下咽缺损方面的优势和局限性。
中国人民解放军总医院耳鼻咽喉头颈外科和首都医科大学附属北京友谊医院耳鼻咽喉头颈外科的高级作者对 27 例Ⅱ-Ⅳ期下咽癌患者采用颏下瓣进行咽重建。
27 例患者中，颏下岛状瓣 96.3%（26/27）存活。有 2 例咽皮瘘，其中 1 例自行愈合，另 1 例与皮瓣坏死有关，行颈部清创和皮瓣切除。除 1 例患者外，其余患者术后 2 周均拔除鼻饲管。除 1 例因放疗引起食管入口狭窄外，无喉咽狭窄或吸入迹象。重建后颏下瓣因胡须生长出现 2 例明显咽部感觉异常。27 例患者中，63.0%（17/27）存活，37.0%（10/27）死于疾病。3 年生存率为 56.3%，5 年生存率为 50.0%。
颏下瓣重建中等大小的非环形下咽缺损是一种推荐的治疗选择。
