Keywords
How to Cite
Abstract
Objectives: present our experience tongue microsurgical reconstruction in patients with oral caner Т2-Т4аN+M0.
Material and methods: prospective study of cases reconstruction of oropharyngeal zone defects after radical operations for cancer from 2015 to 2017 in microsurgery department P. Hertsen Moscow Oncology Research Institute. Total 18 patients included in our study. We used flaps for reconstruction of post-resection defects: small intestine flap (2), radial forearm flap (10), thoracodorsal flap (2) chimeric thoracodorsal flap LDM+ serratus anterior muscle (4).
Results: Reconstruction was successfully completed in 94 % of patients. In all cases was not flap necrosis. Mean follow-up was 16 months. Patients were free air - 89%. Patients were able to feed entirely by mouth - 83%. Speech function was completely restored in 82% of patients after operation. Spontaneous sensory re-innervation occurred in 35% of cases. One patient noted motor neuronal re-innervation. By the end of the 6th month after the operation, speech function was completely restored in 82% of patients.
Conclusions: Attention to the principles of tongue reconstruction and knowledge of the range of available reconstructive options can result in more favorable functional outcomes.
References
Злокачественные новообразования в России в 2017 году (заболеваемость и смертность). Под ред. Каприна А.Д., Старинского В.В., Петровой Г.В. М.: МНИОИ им. П.А. Герцена - филиал ФГБУ «НМИРЦ» Минздрава России, 2016.
Paches A.I. Head and neck tumors. Clinical guidelines. Moscow: Prakticheskaya meditsina, 2013. (In Russ.).
Покровский Н.Б. Расчёт и измерение разборчивости речи. - М.: Гос. изд-во лит. по вопросам связи и радио, 1962. - 391 с.
Polyakov A. P., Kaprin A. D., Ratushnyy M. V., Matorin О. V., Rebrikova I. V., Filyushin M. M., Mordovskiy A. V.,. Nikiforovich P. A. A method for restoring oral cavity and tongue using a composite, free, chimeric, revascularized, reinnerved, musculocutaneous flap after total glossectomy. Head and Neck tumors 2017; №3; DOI: 10.17650/2222-1468-2017-7-3-12-18
Reshetov I. V. Chissov V. I., Kravtsov S. A., Ratushnyy M. V. "The method of tongue reconstruction in patients with extensive defects of the oral cavity". No. 2009108780/14; application: 10.03.2009, published: 20.06.2010. Available from:http://www.findpatent.ru/patent/254/2546097.html (In Russ.).
Camaioni A., Loreti A., Damiani V., Bellioni M., Passali F., Viti C. Anterolateral thigh cutaneous flap vs. radial forearm free-flap in oral and oropharyngeal reconstruction: an analysis of 48 flaps. Acta Otorhinolaryngologica Italica. 2008;28(1):7-12.
Chien C.Y., Su C.Y., et al. Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: Functional outcomes European Journal of Surgical Oncology (EJSO), Volume 32, Issue 3, Pages 353-357 D0I:. DOI: 10.1016/j.ejso.2005.12.010
Chong V. Oral cavity cancer. Cancer Imaging 2005; 5(Spec No A): S49-S52. PMCID: 1665311 10.1102/1470 7330.2005.0029. DOI: 10.1102/14707330.2005.0029
Haughey B.H.: Tongue Reconstruction: Concepts and Practice. Laryngoscope 1993;103(10):1132-41. PMID: 8412450. DOI: 10.1288/00005537-199310000-00010
Kapur K., Garrett N., Fischer E. Effects of oral anesthesia on food manipulation during mastication. Arch Oral Biol 1990;35:397-403.
Kimata Y., Uchiyama K., Ebihara S., et al. Postoperative complications and functional results after total glossectomy with microvascular reconstruction. Plast. Reconstr. Surg. 2000 Oct;106(5):1028-35. PMID: 11039374.
Liu W.W., Hao Li, Zhu-ming Guo, Quan Zhang, An-Kui Yang, Xue-kui Liu, Ming Song Reconstruction of soft-tis-sue defects of the head and neck: radial forearm flap or anterolateral thigh flap? Eur Arch Otorhinolaryngol. 2011 Dec;268(12):1809-12. Epub 2011 Mar. DOI: 10.1007/s00405-011-1548-4
Lu M., Sun G., Hu Q., Tang E., Wang Y. Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects. Medicina Oral, Patologia Oral y Cirugia Bucal. 2015;20(6):e757-e762. DOI: 10.4317/medoral.20727
Mosier K., Liu W.C., Behin B., et al. Cortical adaptation following partial glossectomy with primary closure: impli cations for reconstruction of the oral tongue. Ann Otol Rhinol Laryngol 2005; 114:681-687. PMID: 16240930 DOI: 10.1177/000348940511400905
National Comprehensive Cancer Network. Head and Neck Cancers V. 2.2017. NCCN. Available at http://www.ccn. org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed: May 8, 2017.
Peirong Yu, Geoffrey L. Robb. Reconstruction for Total and Near-Total Glossectomy Defects Clinics in Plastic Surgery, 2005; Volume 32, Issue 3, Pages 411-419 DOI: 10.1016/j.cps.2005.02.005
Rapidis A.D., Gullane P., Langdon J.D., Lefebvre J.L., Scully C., Shah J.P. Major advances in the knowledge and understanding of the epidemiology, aetiopathogenesis, diagnosis, management and prognosis of oral cancer. Oral Oncol. 2009;45:299-300. PMID: 19411038, DOI: 10.1016/j.oraloncology.2009.04.001
Semmes, J., Weinstein, S., Ghent, L., and Teuber, H. Somatosensory changes after penetrating brain wounds in man. Harvard University Press, Cambridge, MA; 1960
Song YG., Chen G.Z., Song YL. The free thigh flap: a new flap concept based on the septocutaneous artery. Br J. Plast Surg 1984;37:149-59. PMID: 6713155.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2019