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舌癌手术切除后的功能结局;一期缝合、二期愈合与皮瓣重建的比较研究

Functional Outcomes After Surgical Resection of Tongue Cancer; A Comparative Study Between Primary Closure, Secondary Intention Healing and Flap Reconstruction.

作者信息

Ravindra Aditi, Nayak Dipak Ranjan, Devaraja K, Matthew Neethu M, Tiwari Shivani

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, 4th floor, New OPD Building, Manipal, Karnataka India.

Department of Speech and Hearing, Kasturba Medical College, Manipal, Karnataka India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6296-6306. doi: 10.1007/s12070-021-03038-1. Epub 2022 Jan 5.

Abstract

The purpose of the study was to assess and compare the quality of speech and swallowing between three reconstruction options (-group A, group B and group C), in small to moderate sized onco-surgical defects of oral tongue. 47 patients fulfilled the eligibility criteria during the study period, of which, 15 belonged to group A, 16 belonged to group B, 16 were in group C. Speech and swallowing assessment was done using Speech Intelligibility Assessment score and MD Anderson Dysphagia Inventory, respectively. The above tests were administered pre-operatively, 1 month and 6 months post-operativey in all the study participants. The average scores of speech intelligibility at 1 month were 66.13% (±19.96), 70.04% (±12.28) and 37.31% (±11.29) for groups A, B and C respectively. Similarly, average long term scores for speech intelligibility in these three groups were 72.7% (±17.72), 83.3% (±12.78) and 52.8% (±11.74) respectively. With regards to swallowing the composite scores at 1 month were 73.67 (±13.69), 68.31 (±16.06) and 41.81 (±5.44), and at 6 months were 83.2 (±10.24), 79.31 (±12.29) and 57.88 (±7.37), respectively for groups A, B and C. All the differences were statistically significant ( < 0.05). Healing by secondary intention offered the best functional outcome in terms of speech intelligibility, and primary closure offered best swallowing outcomes in operated cases of oral tongue. This trial has been registered with the Clinical Trials Registry-India in December 2018 (CTRI Reg. No: CTRI/2018/12/016803).

摘要

本研究的目的是评估和比较三种重建方案(A组、B组和C组)在中小型口腔舌部肿瘤手术缺损患者中的言语和吞咽质量。在研究期间,47例患者符合入选标准,其中15例属于A组,16例属于B组,16例属于C组。分别使用言语清晰度评估分数和MD安德森吞咽量表进行言语和吞咽评估。上述测试在所有研究参与者术前、术后1个月和6个月进行。A组、B组和C组术后1个月的言语清晰度平均得分分别为66.13%(±19.96)、70.04%(±12.28)和37.31%(±11.29)。同样,这三组言语清晰度的平均长期得分分别为72.7%(±17.72)、83.3%(±12.78)和52.8%(±11.74)。关于吞咽,A组、B组和C组术后1个月的综合得分分别为73.67(±13.69)、68.31(±16.06)和41.81(±5.44),术后6个月分别为83.2(±10.24)、79.31(±12.29)和57.88(±7.37)。所有差异均具有统计学意义(<0.05)。就言语清晰度而言,二期愈合在功能结果方面最佳,而一期缝合在口腔舌部手术病例中吞咽结果最佳。本试验已于2018年12月在印度临床试验注册中心注册(CTRI注册号:CTRI/2018/12/016803)。

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