De Virgilio Armando, Bellini Elisa, Pace Gian Marco, Costantino Andrea, Festa Bianca Maria, Iandelli Andrea, Russo Elena, Sampieri Claudio, Peretti Giorgio, Spriano Giuseppe, Marchi Filippo
Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.
Eur Arch Otorhinolaryngol. 2023 Dec;280(12):5177-5191. doi: 10.1007/s00405-023-08191-7. Epub 2023 Aug 24.
The aim of this study is to analyze functional outcomes of soft palate reconstruction after oncologic surgery.
This study was conducted in conformity with the PRISMA statement. A single arm meta-analysis was performed for feeding tube dependence (FTD) (primary outcome), velopharyngeal insufficiency (VPI) and hypernasality (HN) (secondary outcomes) incidences.
A total of 510 patients (males: 77.75%, n = 353/454) with a median age of 58 years (n = 480/510; 95% CI 57.0-61.0) who underwent soft palate surgical resection with primary reconstruction were included. Overall, the cumulative FTD rate was 1.55% (n = 28/510; 95% CI 0.24-3.96%), the VPI rate was 22.18% (n = 119/379; 95% CI 12.99-33.02%), and the HN rate was 33.01% (n = 88/234; 95% CI 19.03-46.61%).
Soft palate reconstruction results in a low incidence of FTD, and most patients resume a full oral diet. Both obturators, primary closure, local and free flaps seem good reconstructive options. Nevertheless, more specific postoperative functional deficiencies like VPI and HN owns higher incidences, potentially affecting the quality of the swallowing and speaking function and the patient's quality of life.
本研究旨在分析肿瘤手术后软腭重建的功能结局。
本研究按照PRISMA声明进行。对置管依赖(FTD)(主要结局)、腭咽闭合不全(VPI)和鼻音过重(HN)(次要结局)的发生率进行单臂荟萃分析。
共纳入510例接受软腭手术切除并一期重建的患者(男性:77.75%,n = 353/454),中位年龄58岁(n = 480/510;95%CI 57.0 - 61.0)。总体而言,累积FTD发生率为1.55%(n = 28/510;95%CI 0.24 - 3.96%),VPI发生率为22.18%(n = 119/379;95%CI 12.99 - 33.02%),HN发生率为33.01%(n = 88/234;95%CI 19.03 - 46.61%)。
软腭重建导致FTD发生率较低,且大多数患者恢复正常经口饮食。阻塞器、一期缝合、局部和游离皮瓣似乎都是良好的重建选择。然而,VPI和HN等更具体的术后功能缺陷发生率较高,可能影响吞咽和言语功能质量以及患者生活质量。