Functional evaluation of anterolateral thigh flap and forearm flap for repairing defects after oropharyngeal cancer
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摘要: 目的 探讨股前外侧皮瓣与前臂皮瓣修复口咽鳞状细胞癌术后缺损的口咽功能恢复情况。方法 回顾性研究2016年9月—2020年9月在山西医科大学第一医院口腔科完成的37例口咽癌术后软组织缺损行股前外侧皮瓣或前臂皮瓣修复的患者资料，其中22例采用前臂皮瓣修复，15例采用股前外侧皮瓣修复，比较2组皮瓣制备成活率、血管危象发生率，并评估患者术后的吞咽、言语、腭咽闭合等功能。结果 21例前臂皮瓣成活，1例出现血管危象，手术探查后未能成活，取对侧前臂皮瓣移植后成活。14例股前外侧皮瓣成活，2例皮瓣出现血管危象，其中1例手术探查去除血栓后皮瓣成活，另1例皮瓣坏死，改为胸大肌皮瓣修复。2种皮瓣修复术后患者的吞咽、言语、腭咽闭合等功能均有较高的满意度。结论 对于口咽癌术后的软组织缺损，前臂皮瓣或股前外侧皮瓣可达到良好的功能修复，需根据具体情况选择。Abstract: Objective To investigate the oropharyngeal function recovery of oropharyngeal squamous cell carcinoma repaired by anterolateral thigh flap and forearm flap.Methods Retrospective study between September 2016 and September 2020 complete line 37 cases of oropharyngeal cancer postoperative soft tissue defect of femoral anterolateral flap or forearm flap to repair the patient data, in which 22 cases, using the forearm skin flap to repair 15 cases with femoral anterolateral flap, flap survival rate of preparation, compare the two groups, the incidence of vascular crisis, The functions of swallowing, speech, and velopharyngeal closure were evaluated.Results 21 cases of forearm flaps survived, and 1 case had vascular crisis. After surgical exploration, the contralateral forearm flaps survived transplantation. Fourteen anterolateral femoral flaps survived, 2 flaps had vascular crisis, and 1 flap survived after thrombus removal. The other one was repaired with pectoralis major myocutaneous flap for necrosis. Swallowing, speech, palatopharyngeal closure and other functions of the patients after the two kinds of flap repair had higher satisfaction.Conclusion Forearm flap and anterolateral thigh flap are good choices for soft tissue defect after oropharyngeal cancer, Must act according to the special details choice appropriate therapeutic schedule.
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表 1 2组口咽癌患者的皮瓣修复效果比较
组别 言语功能 吞咽功能 腭咽闭合功能 一等 二等 三等 一级 二级 三级 正常 较差 不全 前臂组 9 12 1 6 15 1 20 2 0 股前外组 2 10 2 3 10 1 12 2 0 χ2 3.3358 0.234 0.221 P >0.05 >0.05 >0.05 
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