舌口底再建に用いられた大胸筋皮弁の臨床的検討 : 手術術式と術後機能の関連について

概要

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Our experience with 19 consecutive pectoralis major myocutaneous flaps was reviewd. Correlation between technical detail and long term results, especially speech function, were discussed. Also surgical complications and their causes were analyzed in some clinical cases. Conclusions are as follows; 1. Monosyllable intelligibility scores after operation decreased according to the resection area of tongue. For example, partial glossectomy: 81.9%, hemiglossectomy: 71.5% and subtotal glossectomy: 39.3%. 2. Monosyllable intelligibility scores changed according to the flap suture position. In the high suture position the score was 64.6%. And in the low suture position it was 42.3%. 3. Surgical complications after the operation were 3 cases, of orocutaneous fistura, 3 cases of partial nectosis and 2 cases of facial edema. All cases of orocutaneous fistula were low position ones. 4. Muscle atrophy of the flap was observed in all cases. Therefore in reconstructing the tongue with pectoralis major myocutaneous flap, over correction of the tongue is necessary. 5. Severe hyperkeratosis and hair regrowing from the flap were observed in 5 cases each.