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话题:舌癌根治术同期前臂皮瓣重建半舌对患者(中华整形外科杂志)

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潘朝斌大夫

中山大学孙逸仙纪念医院

口腔颌面-头颈外科

发表于:2011-06-08

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舌癌根治术同期前臂皮瓣重建半舌对患者

语言功能恢复的效果研究

 

中山大学附属第二医院 口腔颌面外科 广州,510120

潘朝斌 黄洪章 赵小朋 李劲松 张彬

 

摘要

 目的: 舌癌根治手术导致舌、口底等大范围的组织缺损,必然影响患者术后语言、咀嚼、及吞咽等功能,导致生存质量不同程度下降。半舌缺损是否需要重建,目前尚有争论。本研究旨在比较舌癌根治导致半舌缺损同期前臂皮瓣修复与直接拉拢缝合术后患者语言功能恢复效果的差异。

方法: 选取2004年1月至2005年6月间在我科治疗的36例舌癌患者为对象,其中16例半舌切除后直接拉拢缝合,20例半舌切除后行前臂皮瓣修复。手术治疗6个月后,语音清晰度评价语言功能,VS-9700语音工作站对患者“鸡[ji]、书[shu]、轮[lun]”的发音进行语音频谱分析。两组资料的检验用t检验,以SPSS10.0统计分析软件进行统计学分析。

结果: (1)前臂皮瓣修复组患者语言清晰度高于直接拉拢缝合组,两组之间有统计差异(P <0.05)。(2)直接拉拢缝合组患者“鸡[ji]”音第一、第二共振峰值明显高于对照组(P <0.05),前臂皮瓣与对照组差异无统计学意义(P >0.05)。(3)直接拉拢缝合组、前臂皮瓣修复组“书[shu]”音的第一、第二共振峰值低于对照组(P <0.05)。(4)直接拉拢缝合组“轮[lun]”音的第一共振峰值低于对照组(P <0.05),前臂皮瓣修复组与对照组差异无统计学意义(P >0.05)。

结论  前臂皮瓣修复半舌缺损术后患者语言功能恢复优于直接拉拢缝合。

 

关键词:舌肿瘤,游离组织瓣移植,语音频谱分析,半舌缺损

 

 

 

Study on the Speech Function Effect of Reconstruction

With Forearm Flaps after Hemiglossectomy

 

PAN Chao-bin, HUANG Hong-zhang, ZHAO Xiao-peng, LI Jin-song,  ZHANG Bin   Department of Oral and Maxillo-facial Surgery, the Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, China

 

Abstract

Objective: Presently, radical operation is dominant in comprehensive treatment of TSCC. Hemiglossectomy is usually done in stage T2 and advanced TSCC cases. Hemiglossectomy can result in the decline of speech, chewing and swallowing function of the patients. There is still debate upon whether it is necessary to reconstruct the hemitongue defect with flaps. This study is to compare the difference of clinical effect after reconstruction of hemitongue defect with forearm flap (FAF) and primary closure (PC); and provide references for clinical treatment.

Methods: 36 patients who underwent hemiglossectomy were investigated after surgery for TSCC. 20 cases were reconstructed with FAF, 16 with primary closure. The patients’ speech function was evaluated by articulation test. VS-9700 was used to analyze the speech character when they pronounce [ji], [shu], [lun]. The statistical analysis was done by SPSS10.0.

Results: (1) The speech articulation of patients who underwent hemitongue reconstruction with FAFs better than that of patients PC, and there was significant difference between them (P<0.05). (2) The first formant (F1) and the second formant (F2) of [ji] of PC group was higher than those of control group (P<0.05). There were no significant differences between FAF and control group in F1 and F2 of [ji] (P >0.05). (3) The F1 and F2 of [shu] of every experiment group were lower than those of control group (P< 0.05). (4) The F1 of [lun] of PC group was lower than that of control group (P<0.05). There were no significant differences between FAF group and control group in F1 of [lun] (P >0.05).

 Conclusions: The patients underwent hemitongue reconstruction with FAF achieved better speech than those patients underwent hemiglossectomy with primary closure.

 

Keywords: Tongue neoplasm; Free tissue flaps transplant; Spectrum analysis of speech; Hemitongue defect

希望此文对大家有帮助,欢迎大家在这里跟帖讨论,发表自己的心得与感想。祝大家早日康复!

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舌癌

发表于:2011-11-06

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我们这个病人是在2009年作的舌癌局部切除,基本上对语言的影响不大,只是个别的字有些咬不清,2011年又做了原位的局切,对语言的影响不太大。

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发表于:2014-07-08

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希望天下病友早日康复!

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舌癌

发表于:2015-04-29

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好人一生平安,感谢白衣天使~~