Evaluation of a reconstruction method for tongue, floor of mouth and oropharynx using free tissue transfer with reference to postoperative swallowing function.

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概要

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• This study was conducted to investigate postoperative swallowing function, functional reconstructive method and a preventive aspiration method for defects of the tongue, floor of the mouth and oropharynx using free tissue transfer in 41 patients who had undergone resection of advanced oral cancer. The free tissue transfer used included 29 (71%) anterolateral or anteromedial thigh flaps, 5 radial forearm flaps, 5 rectus abdominis flaps and 2 fibula osteocutaneous flaps. The defect resulting from resection of half of the oral tongue or hemiglossectomy was reconstructed with a pliabel and large flap, such as an anterolateral thigh flap, a rectus abdominis flap or a radial forearm flap to preserve mobility of the residual tongue. Superior swallowing function was achieved in this surgical group. Defects following subtotal or total glossectomy were reconstructed with a large anterolateral thigh flap that was packed by a de-epithelialized proximal portion of the flap to provide bulk for the neotongue. Postoperatively, three of five patients who underwent this reconstruction experienced severe dysphagia. A reconstructive technique that provides bulk for the neotongue and counteracts the loss in tongue height is required. Further laryngeal suspension to prevent aspiration should be performed at the time of reconstruction.<BR>Combined defects of the soft palate and oropharyngeal wall were reconstructed with an anterolateral thigh flap, the distal portion of which was made thinner for soft palate repair by the removal of fatty tissue. The de-epithelialized proximal portion was packed to provide bulk for the lateral wall. The reconstructed soft palate showed sufficient synchronized motion with the remaining soft palate. Good velopharyngeal closure and swallowing function were achieved with this reconstructive method.

• 一般社団法人 日本口腔腫瘍学会の論文

一般社団法人 日本口腔腫瘍学会 | 論文

• 進行口腔癌に対する逆行性超選択的動注化学療法, 放射線同時併用療法後の救済手術
• TS-1による化学療法と温熱放射線療法が著効した後発頸部リンパ節転移の1例
• 手術シミュレーションに基づく腫瘍分割摘出により顎骨を保存した得た下顎骨骨形成線維腫の1例
• 口腔癌における化学・放射線療法後の再発・二次再建に関する外科療法の検討
• 下顎骨再建 : 血管柄付遊離骨移植と遊離軟部組織移植の比較

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