Pyne Justin M, Dziegielewski Peter T, Constantinescu Gabriela, Dzioba Agnieszka, O'Connell Daniel A, Côté David W J, Ansari Khalid, Harris Jeffrey, Conrad Dustin, Makki Fawaz M, Hearn Matthew, Biron Vincent L, Seikaly Hadi
Department of Surgery, Division of Otolaryngology - Head and Neck Surgery University of Alberta Edmonton Alberta Canada.
Department of Otolaryngology University of Florida Gainesville Florida USA.
Laryngoscope Investig Otolaryngol. 2020 Aug 14;5(5):853-859. doi: 10.1002/lio2.435. eCollection 2020 Oct.
The tongue is an essential organ for human interaction, communication and survival. To date, there is a paucity of objective functional, patient reported, or quality of life outcomes of patients undergoing a total glossectomy with preservation of the larynx (TGLP).
To examine prospectively collected objective, self-reported functional and quality of life (QOL) data in patients undergoing TGLP and free flap reconstruction.
Sixteen TGLP patients were identified in the prospective head and neck cancer and functional outcomes database between January of 2009 and December 2017. Data collection included patient age, sex, performance status, TNM staging, diagnosis and adjuvant treatment. Swallowing and speech functions were measured and prospectively recorded pre- and postoperatively. Patient reported outcomes were measured with the Speech Handicap Index (SHI) and the M.D. Anderson Dysphagia Inventory (MDADI).
All patients had a significant reduction in their objective swallowing ( = 0.035), sentence ( = 0.001) and word intelligibility ( < .001) scores. There was no significant reduction in SHI or total MDADI scores. All patients maintained their QOL in the post-treatment time frame. There was no relationship between free-flap type and outcome.
Total glossectomy with laryngeal sparing and free flap reconstruction results in significant reduction in objective functional measurements, but patients report stable functional and quality of life outcomes after treatment.
舌头是人类互动、交流和生存的重要器官。迄今为止，对于接受保留喉功能的全舌切除术（TGLP）的患者，缺乏客观的功能、患者报告结局或生活质量方面的研究。
研究前瞻性收集的接受TGLP和游离皮瓣重建患者的客观、自我报告的功能及生活质量（QOL）数据。
在2009年1月至2017年12月的前瞻性头颈癌及功能结局数据库中确定了16例TGLP患者。数据收集包括患者年龄、性别、体能状态、TNM分期、诊断及辅助治疗。术前和术后测量并前瞻性记录吞咽和言语功能。使用言语障碍指数（SHI）和MD安德森吞咽障碍量表（MDADI）测量患者报告结局。
所有患者的客观吞咽（P = 0.035）、句子清晰度（P = 0.001）和单词清晰度（P < 0.001）评分均显著降低。SHI或MDADI总分无显著降低。所有患者在治疗后的时间段内维持了其生活质量。游离皮瓣类型与结局之间无关联。
保留喉功能的全舌切除术和游离皮瓣重建导致客观功能测量值显著降低，但患者报告治疗后功能和生活质量结局稳定。
