Objective: To investigate the efficacy of anterolateral thigh flap preforming tongue in patients with total glossectomy. Methods: A total of 27 patients with tongue cancer who underwent total glossectomy, neck lymph node dissection and anterolateral thigh flap transfer were collected from January 2019 to April 2021 in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital. All patients were males, the age ranged from 35-73 years. The patients were divided into experimental (14 cases) and control (13 cases) groups, based on whether the tongue was reconstructed. The clinical parameters of two groups were analyzed by independent sample t test or Fisher exact probability method. Results: The success rate of free flap was 100%, of the patients, 2 patients had cervical hematoma and 1 patient had wound infection postoperatively. There was no difference in speech (6.69±3.42 vs. 5.50±3.01, t=0.96, P=0.346) or swallowing (χ2=0.46, P=0.793) function between two groups at 1 month after surgery. However, the speech (24.94±7.43 vs. 18.44±6.30, t=2.48, P=0.020) and swallowing (χ2=6.97, P=0.008) functions in experimental group were significantly better than those in control group. No case was lost to follow-up. All patients were extubated after operation, with average time of 7.2 days in the experimental group and 7.7 days in the control group. The overall survival rate was 71.4% in the experimental group and 61.5% in the control group. Conclusion: The use of anterolateral thigh flap preforming tongue can improve the speech and swallowing functions in patients with total glossectomy and offer a novel method for tongue construction.
目的： 探讨股前外侧游离皮瓣预成形舌体在全舌切除患者中的效果。 方法： 收集2019年1月至2021年4月于中南大学湘雅二医院行全舌切除术及淋巴清扫术，并使用股前外侧游离皮瓣修复重建的病例27例，均为男性患者，年龄35~73岁。依据术中是否采用皮瓣预成形舌体进行分组，试验组为术中使用皮瓣预成形舌体（14例），对照组为术中未预成形舌体（13例）。分析试验组与对照组的临床资料，计量资料、计数资料分别使用独立样本t检验和Fisher确切概率法进行分析。 结果： 2例患者术后颈部血肿，1例患者术后颈部伤口感染，对症处理后均治愈。本研究患者皮瓣成功率为100%。试验组和对照组术后1个月语音清晰度［（6.69±3.42）分比（5.50±3.01）分，t=0.96，P=0.346］及吞咽功能（χ2=0.46，P=0.793）差异无统计学意义。术后6个月时，试验组的语音清晰度较对照组明显改善［（24.94±7.43）分比（18.44±6.30）分，t=2.48，P=0.020］，吞咽功能与对照组相比差异有统计学意义（χ2=6.97，P=0.008）。随访6~24个月，无失访病例，所有患者术后均拔除气管套管，拔管时间试验组平均为7.2 d，对照组平均为7.7 d。试验组总生存率为71.4%，对照组总生存为61.5%。 结论： 股前外侧皮瓣预成形舌体的方法可以较好地恢复患者术后的吞咽及言语功能，为全舌切除患者的重建方案提供一种新的选择。.