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
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)。
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
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！