Abstract：
OBJECTIVE: Wide defects resulting from subtotal or total glossectomy are commonly reconstructed using a bulk flap to maintain oral and speech functions. The flap, including muscle tissue, diminishes with time. This study aimed to compare the surgical outcomes of deep inferior epigastric artery perforator and rectus abdominis musculocutaneous free flap reconstructions after glossectomy with laryngeal preservation.
METHODS: Medical records of 13 and 26 patients who underwent deep inferior epigastric artery perforator and rectus abdominis musculocutaneous free flap reconstructions, respectively, from 2014 to 2022 at our institution were reviewed. Patients who underwent middle pharynx resection except for the base of the tongue, mandibular bone resection, and sensory reinnervation were excluded.
RESULTS: The rectus abdominis musculocutaneous groups showed a higher number of lymph node dissection and shorter operative time than the deep inferior epigastric artery perforator groups. No significant differences in postoperative complications or functional oral intake scale scores at 6 months were observed. Volumetric changes on computed tomography images at 6 and 12 months were significantly lower in the deep inferior epigastric artery perforator group. Cancer recurrence was significantly associated with reduced oral function.
CONCLUSIONS: Oral function in patients with cancer is influenced by various other factors. However, the deep inferior epigastric artery perforator flap may be suitable for tongue reconstruction because of the minimal postoperative changes in flap volume, easy adjustment of flap thickness, elevation of multiple flaps, and minimal complications at the donor site.
METHODS: Medical records of 13 and 26 patients who underwent deep inferior epigastric artery perforator and rectus abdominis musculocutaneous free flap reconstructions, respectively, from 2014 to 2022 at our institution were reviewed. Patients who underwent middle pharynx resection except for the base of the tongue, mandibular bone resection, and sensory reinnervation were excluded.
RESULTS: The rectus abdominis musculocutaneous groups showed a higher number of lymph node dissection and shorter operative time than the deep inferior epigastric artery perforator groups. No significant differences in postoperative complications or functional oral intake scale scores at 6 months were observed. Volumetric changes on computed tomography images at 6 and 12 months were significantly lower in the deep inferior epigastric artery perforator group. Cancer recurrence was significantly associated with reduced oral function.
CONCLUSIONS: Oral function in patients with cancer is influenced by various other factors. However, the deep inferior epigastric artery perforator flap may be suitable for tongue reconstruction because of the minimal postoperative changes in flap volume, easy adjustment of flap thickness, elevation of multiple flaps, and minimal complications at the donor site.
摘要：
目的：由舌部次全或全切导致的广泛缺损通常使用块状皮瓣修复，以维持口腔和言语功能。襟翼，包括肌肉组织,随着时间的推移而减少。本研究旨在比较保留喉的舌切除术后深腹壁下动脉穿支和腹直肌肌皮瓣重建的手术效果。
方法：13和26例接受深腹壁下动脉穿支和腹直肌游离皮瓣重建的患者的病历，分别,从2014年到2022年在我们的机构进行了审查。除舌根外接受咽中段切除术的患者，下颌骨切除，排除了感觉神经支配。
结果：与腹壁下动脉穿支组相比，腹直肌肌组的淋巴结清扫次数更多，手术时间更短。术后并发症或6个月功能性口腔摄入量表评分无显著差异。在深腹下动脉穿支组中，6个月和12个月时计算机断层扫描图像上的体积变化显着降低。癌症复发与口腔功能降低显著相关。
结论：癌症患者的口腔功能受多种其他因素的影响。然而,腹壁下深动脉穿支皮瓣术后皮瓣体积变化小,可用于舌重建,方便调整皮瓣厚度，多个襟翼的高度,和最小的并发症在捐赠部位。
方法：13和26例接受深腹壁下动脉穿支和腹直肌游离皮瓣重建的患者的病历，分别,从2014年到2022年在我们的机构进行了审查。除舌根外接受咽中段切除术的患者，下颌骨切除，排除了感觉神经支配。
结果：与腹壁下动脉穿支组相比，腹直肌肌组的淋巴结清扫次数更多，手术时间更短。术后并发症或6个月功能性口腔摄入量表评分无显著差异。在深腹下动脉穿支组中，6个月和12个月时计算机断层扫描图像上的体积变化显着降低。癌症复发与口腔功能降低显著相关。
结论：癌症患者的口腔功能受多种其他因素的影响。然而,腹壁下深动脉穿支皮瓣术后皮瓣体积变化小,可用于舌重建,方便调整皮瓣厚度，多个襟翼的高度,和最小的并发症在捐赠部位。
