Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.
Oral Oncol. 2023 Dec;147:106596. doi: 10.1016/j.oraloncology.2023.106596. Epub 2023 Oct 13.
This systematic review aims to provide insight into the ideal reconstructive approach of the oral tongue in oral tongue cancer (OTC) by investigating the relationship between functional outcomes and the extent of tongue resection. A structured search was performed in Ovid MEDLINE, EMBASE, and Web of Science. Studies comparing patient-reported and objective measurements of the oral tongue function between flap vs. non-flap reconstruction were included. Functional outcomes of interest were speech production, deglutition efficiency, tongue mobility, overall quality of life, and postoperative complications. A total of nine studies were retrieved and critically appraised. Patients with 20 % or less of oral tongue resected had superior swallowing efficiency and speech intelligibility with a non-flap reconstruction while patients with a tongue defect of 40-50 % self-reported or demonstrated better swallowing function with a flap repair. The data in intermediate tongue defects (20-40 % tongue resected) was inconclusive, with several studies reporting comparable functional outcomes between approaches. A longitudinal multi-institutional prospective study that rigidly controls the extent of tongue resected and subsites involved is needed to determine the percentage of tongue resected at which a flap reconstruction yields a superior functional result in OTC.
本系统评价旨在通过研究口腔舌癌（OTC）中功能结果与舌切除范围之间的关系，深入了解口腔舌的理想重建方法。在 Ovid MEDLINE、EMBASE 和 Web of Science 中进行了结构化搜索。纳入了比较瓣状与非瓣状重建患者口腔舌功能的患者报告和客观测量之间关系的研究。感兴趣的功能结果包括言语产生、吞咽效率、舌运动、整体生活质量和术后并发症。共检索到 9 项研究并进行了批判性评价。在切除 20%或更少的口腔舌时，非瓣状重建的吞咽效率和言语清晰度更高，而切除 40-50%的口腔舌的患者报告或表现出更好的吞咽功能，使用瓣状修复。中间舌缺损（切除 20-40%的舌）的数据尚无定论，有几项研究报告了两种方法之间可比的功能结果。需要进行一项严格控制舌切除范围和涉及部位的纵向多机构前瞻性研究，以确定在 OTC 中，瓣状重建产生更好功能结果的舌切除百分比。
