Choi Jong-Woo, Alshomer Feras, Kim Young-Chul
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Arch Craniofac Surg. 2022 Aug;23(4):139-151. doi: 10.7181/acfs.2022.00654. Epub 2022 Aug 20.
Reconstructive surgery in the management of head and neck cancer has evolved to include structure-specific approaches in which organ-specific treatment algorithms help optimize outcomes. Tongue cancer management and reconstruction are surgical challenges for which well-executed reconstructive plans should be completed promptly to avoid delaying any subsequently planned oncologic treatment. Crucial considerations in tongue cancer resection are the significant functional morbidity associated with surgical defects, particularly in terms of speech and swallowing, and the consequent negative impact on patients' quality of life. With the evolution of microsurgical techniques and the development of the perforator flap concept, flap options can be tailored to the characteristics of various tongue defects. This has allowed the implementation of pliable flaps that can help restore tongue mobility and yield subsequent functional outcomes. Using an evolutional framework, we present this series of reviews related to tongue reconstruction. The first part of the review summarizes flap options and flap-related factors, such as volume and tissue characteristics. Related functional aspects are also presented, including tongue mobility, speech, and swallowing, as well as ways to evaluate and optimize these outcomes.
头颈部癌症管理中的重建手术已经发展到包括针对特定结构的方法，其中特定器官的治疗算法有助于优化治疗结果。舌癌的管理和重建是外科手术面临的挑战，对于这些挑战，应迅速完成执行良好的重建计划，以避免延误任何后续计划的肿瘤治疗。舌癌切除术中的关键考虑因素是与手术缺损相关的显著功能障碍，特别是在言语和吞咽方面，以及对患者生活质量的相应负面影响。随着显微外科技术的发展和穿支皮瓣概念的出现，皮瓣选择可以根据各种舌缺损的特点进行定制。这使得能够采用柔韧的皮瓣，有助于恢复舌的活动能力并产生后续的功能结果。我们使用一个演进框架，呈现这一系列与舌重建相关的综述。综述的第一部分总结了皮瓣选择和与皮瓣相关的因素，如体积和组织特征。还介绍了相关的功能方面，包括舌的活动能力、言语和吞咽，以及评估和优化这些结果的方法。
