Deva Faizah Ashfah Latief, Kalsotra Gopika, Kalsotra Parmod, Saraf Aditiya
Jammu, J&K India Department of ENT & HNS, GMC and SMGS Hospital.
Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):529-539. doi: 10.1007/s12070-022-03380-y. Epub 2022 Dec 17.
To compare postoperative complications, functional rehabilitation, surgical outcomes of the radial artery forearm free flap (RAFFF) and split thickness skin graft (STSG) reconstruction of postsurgical defect in T2 lesions of cancer oral cavity. Observational Prospective comparative study. Academic tertiary referral centre. In our study of forty four patients, after tumour resection, half underwent reconstruction using RAFFF (Group I) and another half by STSG (Group II). All of the patients were followed postoperatively to determine and compare their functional outcomes related to donor site and recipient site complications, speech, deglutition and mouth opening. The speech intelligibility and deglutition were each assessed using Articulation Handicap Index and Vedio-fluoroscopy using the Functional oral intake scale. Operative time for STSG reconstruction was shorter at 2.2 ± 0.97 SD hours compared to 5.9 ± 1.24 SD hours for RAFFF reconstruction. Hospital stay was 8.3 ± 1.19 SD days for STSG patients and 12.6 ± 1.7 SD days for RAFFF patients. The functional outcomes of speech quality and swallowing were near comparable in both groups but the donor site complications were significant in the RAFFF group. Operative time, hospital stay and donor site complications are both significantly reduced with the STSG as opposed to RAFF. Functional and oncologic results of both methods are near comparable. To conclude, STSG can be used for reconstruction of the post-surgical defects in T2 lesions of the tongue.
比较口腔癌T2期病变术后缺损采用桡动脉前臂游离皮瓣(RAFFF)和断层皮片移植(STSG)重建的术后并发症、功能康复及手术效果。观察性前瞻性对照研究。学术性三级转诊中心。在我们对44例患者的研究中,肿瘤切除后,一半患者采用RAFFF进行重建(第一组),另一半采用STSG进行重建(第二组)。所有患者术后均进行随访,以确定并比较其与供区和受区并发症、言语、吞咽及张口相关的功能结果。分别使用发音障碍指数和功能性口服摄入量表通过视频透视法评估言语清晰度和吞咽情况。STSG重建的手术时间较短,为2.2±0.97标准差小时,而RAFFF重建为5.9±1.24标准差小时。STSG患者的住院时间为8.3±1.19标准差天,RAFFF患者为12.6±1.7标准差天。两组的言语质量和吞咽功能结果相近,但RAFFF组的供区并发症明显。与RAFF相比,STSG的手术时间、住院时间和供区并发症均显著减少。两种方法的功能和肿瘤学结果相近。总之,STSG可用于舌部T2期病变术后缺损的重建。