head and neck carcinoma

头颈部癌
  • 文章类型: Journal Article
    目的:本研究的目的是评估窄带成像(NBI)在监测头颈部癌治疗后的诊断性能,并与白光内窥镜(WLE)进行比较。
    方法:PubMed,Embase,WebofScience(WOS),科克伦图书馆,中国生物医学光盘(CBM光盘),中国国民知识互联网(CNKI),万方数据,中国科技期刊数据库(CSTJ),中国临床试验注册。
    方法:使用首选报告项目进行系统评价和荟萃分析(PRISMA),搜索了2024年7月之前发表的文献。接受手术的病人,放射治疗(RT),使用NBI分析治疗后随访的头颈部癌或化疗RT。主要结果是敏感性,特异性,治疗后随访中NBI和WLE的诊断比值比(DOR)。
    结果:灵敏度,特异性,NBI和WLE在头颈部癌治疗后随访中的DOR为95%(95%置信区间[CI]:88%-98%),96%(95%CI:92%-98%),433(95%CI:120-1560)和72%(95%CI:49%-87%),72%(95%CI:4%-99%),7(95%CI:0-191)。此外,NBI和WLE的曲线下面积(AUC)值分别为0.99(95%CI:0.97-0.99)和0.75(95%CI:0.71-0.79),分别。病变和患者的数量,治疗方式,随访时间,疾病,和内窥镜系统可能是异质性的来源。
    结论:与WLE相比,NBI在治疗后随访的头颈部癌患者中显示出优异的诊断性能。NBI为早期发现头颈部肿瘤复发提供技术支持和临床基础。
    方法:NA喉镜,2024.
    OBJECTIVE: The purpose of this study was to assess the diagnostic performance of narrow-band imaging (NBI) in monitoring patients with head and neck carcinomas posttreatment and to compare it with that of white light endoscopy (WLE).
    METHODS: PubMed, Embase, Web of Science (WOS), Cochrane Library, China Biology Medicine disc (CBM disc), China National Knowledge Internet (CNKI), Wanfang Data, China Science and Technology Journal Database (CSTJ), Chinese Clinical Trial Register.
    METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), literature published before July 2024 was searched. Patients who underwent surgery, radiotherapy (RT), or chemo-RT for head and neck carcinomas with posttreatment follow-up using NBI were analyzed. The main outcomes were sensitivity, specificity, and diagnostic odds ratio (DOR) for NBI and WLE in posttreatment follow-up.
    RESULTS: The sensitivity, specificity, and DOR for NBI and WLE in posttreatment follow-up for head and neck carcinomas were 95% (95% confidence interval [CI]: 88%-98%), 96% (95% CI: 92%-98%), 433 (95% CI: 120-1560) and 72% (95% CI: 49%-87%), 72% (95% CI: 4%-99%), 7 (95% CI: 0-191). Additionally, the area under the curve (AUC) values for NBI and WLE were 0.99 (95% CI: 0.97-0.99) and 0.75 (95% CI: 0.71-0.79), respectively. The number of lesions and patients, treatment modality, follow-up time, disease, and endoscopic system might be sources of heterogeneity.
    CONCLUSIONS: Compared to WLE, NBI demonstrated superior diagnostic performance in follow-up patients with head and neck carcinoma posttreatment. NBI offers technical support and a clinical foundation for early detection of head and neck carcinoma recurrence.
    METHODS: NA Laryngoscope, 2024.
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  • 文章类型: Journal Article
    介绍我们使用锁骨上动脉岛状皮瓣(SCAIF)进行头颈部重建的经验。
    我们进行了回顾性图表回顾,以确定在我们机构接受SCAIF头颈部重建术的患者。收集了以下数据:年龄,性别,手术适应症,皮瓣收获时间,襟翼尺寸,住院时间,并发症,和临床结果。
    33例患者接受了SCAIF重建,其中4人同时行胸大肌肌皮瓣重建。20个皮瓣用于修复扁桃体切除术后的咽或食管缺损,下咽,喉,和颈食管癌。切除气管或甲状腺癌后,使用五个皮瓣进行气管重建。七个皮瓣用于重建与先前治疗相关的宫颈皮肤缺损或瘘。气管切开术后气管狭窄的一个皮瓣。患者的平均年龄为60.69±11.47岁。平均皮瓣收获时间为32.00±4.44分钟。平均皮瓣大小为10.16±3.91×5.78±0.68cm。平均住院时间为24.84±13.78天。三名患者皮瓣远端部分部分坏死,通过抗感染治疗和局部伤口护理解决。一名患者出现了瘘管,通过伤口护理和进一步的手术干预得以解决。未观察到皮瓣完全丢失或主要并发症。未观察到供体部位并发症或肩部功能受损。
    SCAIF可成功用于重建头颈部缺损,结果良好,发病率有限。
    4.
    UNASSIGNED: To present our experience using the supraclavicular artery island flap (SCAIF) for head and neck reconstruction.
    UNASSIGNED: We performed a retrospective chart review to identify patients who underwent head and neck reconstruction with SCAIF at our institution. The following data were collected: age, sex, surgical indications, flap harvest time, flap dimensions, length of hospital stay, complications, and clinical outcomes.
    UNASSIGNED: Thirty-three patients underwent SCAIF reconstruction, of whom four underwent pectoralis major myocutaneous flap reconstruction simultaneously. Twenty flaps were used to repair pharyngeal or esophageal defects following resection for tonsillar, hypopharyngeal, laryngeal, and cervical esophageal cancers. Five flaps were used for tracheal reconstruction following resection for tracheal or thyroid gland cancer. Seven flaps were used for reconstruction of cervical skin defects or fistulas related to a previous treatment. One flap for tracheal stenosis following tracheotomy. The mean age of the patients was 60.69 ± 11.47 years. The mean flap harvest time was 32.00 ± 4.44 min. The mean flap size was 10.16 ± 3.91 × 5.78 ± 0.68 cm. The mean length of hospital stay is 24.84 ± 13.78 days. Three patients had partial necrosis of the distal portion of the flap, which resolved with anti-infection therapy and local wound care. One patient developed a fistula that was resolved with wound care and further surgical intervention. Complete flap loss or major complications were not observed. No donor site complication or compromised shoulder function was observed.
    UNASSIGNED: The SCAIF can be successfully used to reconstruct head and neck defects with good outcomes and limited morbidity.
    UNASSIGNED: 4.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Meta-Analysis
    本文的目的是回顾和共同评估已发表的头颈部癌的体内检测和诊断的光纤拉曼光谱(RS)研究,并得出准确度的共识平均值,敏感性和特异性。
    作者搜索了四个数据库,包括Ovid-Medline,Ovid-Embase,科克伦图书馆,和中国国家知识基础设施(CNKI),直到2023年2月,所有已发表的研究都评估了光纤RS在头颈部癌体内检测中的诊断准确性。根据指定的排除标准筛选出不合格的研究,并排除了有关光纤RS诊断性能的相关信息。发表偏倚是通过Deeks漏斗图不对称检验来估计的。采用随机效应模型计算合并灵敏度,特异性和诊断比值比(DOR)。此外,作者进行了摘要接受者工作特征(SROC)曲线分析和阈值分析,报告曲线下面积(AUC)以评估体内光纤RS的整体性能。
    本文包括10项研究(包括16组数据),从877名患者中获得了总共5365个体内拉曼光谱(癌症=1,746;正常=3,619)。头颈部癌的光纤RS的合并敏感性和特异性分别为0.88和0.94。生成SROC曲线以估计总体诊断准确性,AUC为0.96(95%CI[0.94-0.97])。在Deeks漏斗图不对称检验的荟萃分析中,未发现明显的发表偏倚。这些研究的异质性是显著的;敏感性和特异性的Q检验值分别为106.23(P=0.00)和64.21(P=0.00),分别,敏感性和特异性的I2指数分别为85.88(95%CI[79.99-91.77])和76.64(95%CI[65.45-87.83]),分别。
    光纤RS被证明是一种可靠的技术,用于在体内高精度检测头颈部癌。然而,考虑到这些研究的高度异质性,需要更多的临床研究来减少异质性,并进一步证实了光纤拉曼光谱在体内的实用性。
    UNASSIGNED: The aim of this article was to review and collectively assess the published studies of fiber-optic Raman spectroscopy (RS) of the in vivo detection and diagnosis of head and neck carcinomas, and to derive a consensus average of the accuracy, sensitivity and specificity.
    UNASSIGNED: The authors searched four databases, including Ovid-Medline, Ovid-Embase, Cochrane Library, and the China National Knowledge Infrastructure (CNKI), up to February 2023 for all published studies that assessed the diagnostic accuracy of fiber-optic RS in the in vivo detection of head and neck carcinomas. Nonqualifying studies were screened out in accordance with the specified exclusion criteria, and relevant information about the diagnostic performance of fiber-optic RS was excluded. Publication bias was estimated by Deeks\' funnel plot asymmetry test. A random effects model was adopted to calculate the pooled sensitivity, specificity and diagnostic odds ratio (DOR). Additionally, the authors conducted a summary receiver operating characteristic (SROC) curve analysis and threshold analysis, reporting the area under the curve (AUC) to evaluate the overall performance of fiber-optic RS in vivo.
    UNASSIGNED: Ten studies (including 16 groups of data) were included in this article, and a total of 5365 in vivo Raman spectra (cancer = 1,746; normal = 3,619) were acquired from 877 patients. The pooled sensitivity and specificity of fiber-optic RS of head and neck carcinomas were 0.88 and 0.94, respectively. SROC curves were generated to estimate the overall diagnostic accuracy, and the AUC was 0.96 (95% CI [0.94-0.97]). No significant publication bias was found in this meta-analysis by Deeks\' funnel plot asymmetry test. The heterogeneity of these studies was significant; the Q test values of the sensitivity and specificity were 106.23 (P = 0.00) and 64.21 (P = 0.00), respectively, and the I2 index of the sensitivity and specificity were 85.88 (95% CI [79.99-91.77]) and 76.64 (95% CI [65.45-87.83]), respectively.
    UNASSIGNED: Fiber-optic RS was demonstrated to be a reliable technique for the in vivo detection of head and neck carcinoma with high accuracy. However, considering the high heterogeneity of these studies, more clinical studies are needed to reduce the heterogeneity, and further confirm the utility of fiber-optic Raman spectroscopy in vivo.
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  • 文章类型: Journal Article
    癌症是全球儿童疾病负担的重要组成部分。儿童头颈部肿瘤少见,相关研究有限。本研究旨在探讨儿童头颈部癌的临床病理特征。
    对我院收治的42例儿童头颈部癌病例进行回顾性分析。
    总体年龄中位数为11岁。23例(54.8%)为男性,19例(45.2%)为女性。腮腺部位最常见(54.8%)。粘膜表皮样癌和鳞状细胞癌是最常见的组织学类型(57.1%和11.9%,分别)。两名患者有骨髓移植史,两名患者有牙源性角化囊肿病史。治疗后复发率为8.6%。
    儿童头颈部癌的早期诊断和治疗以及密切随访是必要的,以防止复发和改善临床结果。
    UNASSIGNED: Cancer is an important part of the global burden of childhood diseases. Head and neck carcinoma in children is rare and related research is limited. This study aimed to investigate the clinicopathological features of childhood head and neck carcinoma.
    UNASSIGNED: Forty-two cases of childhood head and neck carcinoma treated in our institution were reviewed and analyzed.
    UNASSIGNED: Median age overall was 11 years. Twenty-three patients (54.8%) were male and 19 (45.2%) were female. Parotid gland location was most common (54.8%). Mucoepidermoid carcinoma and squamous cell carcinoma were the most common histological types (57.1% and 11.9%, respectively). Two patients had a history of bone marrow transplantation and two had a history of odontogenic keratocyst. The recurrence rate after treatment was 8.6%.
    UNASSIGNED: Early diagnosis and treatment and close follow-up of childhood head and neck carcinoma are warranted to prevent recurrence and improve clinical outcome.
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  • 文章类型: Journal Article
    头颈部鳞状细胞癌(HNSCC)与复发有关,远处转移,总体生存率低。这突出了对鉴定具有最小副作用的潜在疗法的需要。本研究旨在研究picrassiineJ,从南亚植物Picrasmaquassioides中分离出的二聚体β-咔啉型生物碱。结果表明,picrasidineJ显著抑制HNSCC细胞运动,迁移,和入侵。具体来说,picrasidineJ通过上调E-cadherin和ZO-1并下调β-catenin和Snail来抑制EMT过程。此外,picrasidineJ降低丝氨酸蛋白酶KLK-10的表达。在信令级别,该化合物降低了ERK的磷酸化。所有这些因素共同促进了picrasidineJ对HNSCC转移的抑制。该研究确定picrasidineJ是植物来源的潜在抗癌化合物,可用于临床预防HNSCC的远处转移和进展。
    Head and neck squamous cell carcinoma (HNSCC) are associated with recurrence, distant metastasis, and poor overall survival. This highlights the need for identifying potential therapeutics with minimal side-effects. The present study was designed to investigate the anticancer effects of picrasidine J, a dimeric β-carboline-type alkaloid isolated from the southern Asian plant Picrasma quassioides. The results showed that picrasidine J significantly inhibits HNSCC cell motility, migration, and invasion. Specifically, picrasidine J inhibited the EMT process by upregulating E-cadherin and ZO-1 and downregulating beta-catenin and Snail. Moreover, picrasidine J reduced the expression of the serine protease KLK-10. At the signaling level, the compound reduced the phosphorylation of ERK. All these factors collectively facilitated the inhibition of HNSCC metastasis with picrasidine J. Taken together, the study identifies picrasidine J as a potential anticancer compound of plant origin that might be used clinically to prevent the distant metastasis and progression of HNSCC.
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  • 文章类型: Clinical Trial
    本研究旨在探讨pembrolizumab联合化疗作为可切除的局部晚期头颈部鳞状细胞癌(LA-HNSCC)患者新辅助治疗的疗效和安全性。
    在这个前景中,单臂,单中心临床试验,符合纳入标准的患者术前接受200mg派姆单抗联合75mg/m2顺铂和175mg/m2紫杉醇的新辅助治疗.随后进行手术和术后辅助治疗。主要终点是术后病理完全缓解(pCR)率。所有统计分析均使用SPSS26进行。
    共纳入22例患者。原发灶位置:下咽15例(68.2%),口咽为6(27.3%),口腔为1(4.5%)。术后pCR率,为36.4%(8/22),并且没有因药物不良反应而延误手术。喉功能保留率为90.9%(20/22)。伤口愈合延迟是主要的手术并发症,发病率为22.7%(5/22)。中位随访时间为9.5个月,只有1例(4.55%)出现区域性复发。
    在可切除的LA-HNSCC中使用派姆单抗和化疗的术前治疗具有较高的pCR率,对手术安全性没有显着影响。发现这种治疗增加了喉功能的保留率。然而,新辅助免疫治疗对LA-HNSCC患者长期预后的影响需要进一步研究.
    This study aimed to explore the efficacy and safety of pembrolizumab combined with chemotherapy as neoadjuvant therapy in patients with resectable locally advanced head and neck squamous cell carcinomas (LA-HNSCCs).
    In this prospective, single-arm, single-centre clinical trial, patients meeting the inclusion criteria were treated with preoperative neoadjuvant therapy with 200 mg pembrolizumab combined with 75 mg/m2 cisplatin and 175 mg/m2 paclitaxel. This was followed by surgery and postoperative adjuvant therapy. The primary endpoint was the postoperative pathological complete response (pCR) rate. All statistical analyses were performed using SPSS 26.
    A total of 22 patients were enrolled. The location of primary lesion showed: hypopharynx were 15 (68.2%), oropharynx were 6 (27.3%) and oral cavity was 1 (4.5%). The postoperative pCR rate, was 36.4% (8/22), and there was no delay to surgery due to adverse drug reactions. The rate of laryngeal function preservation was 90.9% (20/22). Delayed wound healing was the main surgical complication, with an incidence of 22.7% (5/22). The median follow-up time was 9.5 months, and only 1 patient (4.55%) suffered a regional recurrence.
    Preoperative treatment with pembrolizumab and chemotherapy in resectable LA-HNSCC has a high pCR rate with no significant impact on surgical safety. This treatment was found to increase the rate of laryngeal function preservation. However, the effects of neoadjuvant immunotherapy on long-term prognosis in LA-HNSCCs require further study.
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  • 文章类型: Journal Article
    背景:具核梭杆菌(F.核仁)是一种重要的致癌细菌。我们先前的研究表明,头颈部鳞状细胞癌(HNSCC)中F.nucleatum的高丰度与患者预后不良有关。然而,核仁F.对HNSCC代谢重编程和肿瘤进展的影响有待进一步探索。
    方法:应用液相色谱-质谱(LC-MS)分析头颈部癌细胞系(AMC-HN-8)与F共培养后的代谢产物。核仁24小时和48小时。单变量和多变量分析均用于筛选差异代谢物。进一步使用京都基因和基因组百科全书(KEGG)代谢途径富集分析来探索代谢变化。
    结果:我们观察到AMC-HN-8细胞在与核仁F.共培养后随着时间的推移代谢谱显著改变。在几种丰富的途径中,嘌呤代谢途径最显著富集(P=0.0005),嘌呤降解的下调。此外,尿酸,嘌呤代谢的最终产物,显着逆转F.核仁触发的肿瘤进展,并改变细胞内活性氧(ROS)水平。此外,113例HNSCC患者的血尿酸水平与核仁F.丰度呈负相关(P=0.0412,R=-0.1924)。
    结论:我们的研究揭示了HNSCC中由F.nucleatum驱动的明显异常嘌呤代谢,与肿瘤进展和患者预后密切相关。这些发现表明在HNSCC的未来治疗中靶向核仁F.诱导的嘌呤代谢重编程的可能性。
    BACKGROUND: Fusobacterium nucleatum (F. nucleatum) is a vital pro-oncogenic bacterium. Our previous study revealed that a high abundance of F. nucleatum in head and neck squamous cell carcinoma (HNSCC) is correlated with poor patient prognosis. However, the impact of F. nucleatum on metabolic reprogramming and tumor progression in HNSCC awaits more exploration.
    METHODS: Liquid chromatography‒mass spectrometry (LC‒MS) was applied to analyze the altered metabolites in a head and neck carcinoma cell line (AMC-HN-8) after coculture with F. nucleatum for 24 hrs and 48 hrs. Both univariate and multivariate analyses were used to screen for differential metabolites. Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathway enrichment analysis was further used to explore the metabolic changes.
    RESULTS: We observed a significantly altered metabolic profile in AMC-HN-8 cells over time after coculture with F. nucleatum. Among the several enriched pathways, the purine metabolic pathway was the most significantly enriched (P = 0.0005), with downregulation of purine degradation. Furthermore, uric acid, the end product of purine metabolism, significantly reversed F. nucleatum-triggered tumor progression and altered the intracellular reactive oxygen species (ROS) level. Moreover, the negative correlation between the serum uric acid level and the abundance of F. nucleatum was verified in 113 HNSCC patients (P = 0.0412, R = - 0.1924).
    CONCLUSIONS: Our study revealed obviously aberrant purine metabolism driven by F. nucleatum in HNSCC, which was closely related to tumor progression and patient prognosis. These findings indicate the possibility of targeting F. nucleatum-induced purine metabolism reprogramming in the future treatment of HNSCC.
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  • 文章类型: Journal Article
    目的:人类头颈部鳞状细胞癌(HNSCC)是全球第六大最常见的恶性肿瘤。目前,手术切除加化疗和放疗的结合是HNSCC的标准治疗方法,HNSCC患者的5年生存率仍然很低,因为转移和复发的发生率较高。这里,我们旨在研究DNAN6-甲基腺嘌呤(6mA)脱甲基酶ALKBH1在HNSCC肿瘤细胞增殖中的潜在作用。
    方法:采用qRT-PCR和蛋白质印迹法检测10对HNSCC/正常组织和3种HNSCC细胞系中ALKBH1的表达。殖民地的形成,流式细胞术,患者来源的HNSCC类器官测定用于评估ALKBH1在细胞系和人类HNSCC患者HNSCC细胞增殖中的作用.MeDIP-seq,RNA测序,采用斑点印迹法和蛋白质印迹法评价ALKBH1对DEAD-boxRNA解旋酶DDX18表达的调节作用。使用双荧光素酶报告基因测定来评估DNA6mA水平对DDX18转录的推定作用。
    结果:ALKBH1在HNSCC细胞和患者组织中高表达。功能实验表明,ALKBH1在SCC9,SCC25和CAL27细胞中的敲除在体外抑制其增殖。使用患者来源的HNSCC类器官测定,我们发现ALKBH1的敲减抑制了HNSCC患者来源的类器官的增殖和集落形成。此外,我们发现ALKBH1可以通过擦除DNA6mA水平并调节其启动子活性来增强DDX18的表达。ALKBH1缺乏通过抑制DDX18表达阻断肿瘤细胞增殖。DDX18的外源过表达挽救了ALKBH1敲低引起的细胞增殖停滞。
    结论:我们的数据揭示了ALKBH1在调节HNSCC增殖中的重要作用。
    OBJECTIVE: Human head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Currently, surgical resection plus a combination of chemotherapy and radiotherapy is the standard treatment for HNSCC, and the 5-year survival rate of patients with HNSCC remains very low because of the higher incidence of metastasis with consequent recurrence. Here, we aimed to investigate the potential role of DNA N6-methyladenine (6mA) demethylase ALKBH1 in tumor cell proliferation in HNSCC.
    METHODS: The expression of ALKBH1 in 10 pairs of HNSCC/normal tissues and 3 HNSCC cell lines were measured by qRT‒PCR and western blotting. Colony formation, flow cytometry, patient-derived HNSCC organoid assays were used to assess the role of ALKBH1 in HNSCC cell proliferation in cell lines and human HNSCC patients. MeDIP-seq, RNA sequencing, Dot blotting and western blotting were used to evaluate the regulatory effect of ALKBH1 on the expression of DEAD-box RNA helicase DDX18. A dual-luciferase reporter assay was used to assess the putative effect of DNA 6mA levels on DDX18 transcription.
    RESULTS: ALKBH1 was highly expressed in HNSCC cells and patient tissues. Functional experiments revealed that ALKBH1 knockdown in SCC9, SCC25, and CAL27 cells inhibited their proliferation in vitro. Using patient-derived HNSCC organoid assay, we found that knockdown of ALKBH1 inhibited the proliferation and colony formation of HNSCC patients-derived organoids. Moreover, we found that ALKBH1 can enhance DDX18 expression by erasing DNA 6mA level and regulating its promoter activity. ALKBH1 deficiency blocked tumor cell proliferation by inhibiting DDX18 expression. Exogenous overexpression of DDX18 rescued the cell proliferation arrest caused by ALKBH1 knockdown.
    CONCLUSIONS: Our data reveal the important role of ALKBH1 in regulating proliferation of HNSCC.
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  • 文章类型: Journal Article
    我们旨在评估头颈部癌(HNC)患者的生活质量,这些患者接受了双桨腓骨动脉穿支(DPAP)游离皮瓣的软组织切除和重建。术后12个月通过华盛顿大学生活质量(UW-QOL)和14项口腔健康影响概况(OHIP-14)问卷评估生活质量。对57例患者的数据进行回顾性分析。在这些中,51例患者处于TNM分期III或IV期。最后,48名患者完成并返回了两份问卷。在UW-QOL问卷中,平均(SD)较高的分数是疼痛76.5(6.4),肩部74.3(9.6),和活动71.6(6.1),而较低的分数是咀嚼49.7(5.2),味道51.1(7.7),和唾液(56.7(7.4)。在OHIP-14问卷中,得分较高的领域是心理不适(69.3(9.6)和心理残疾65.2(5.8),而得分较低的领域是障碍28.7(4.3)和身体疼痛30.4(8.1)。DPAP游离皮瓣外观明显改善,活动,肩膀,心情,心理不适,与带蒂胸大肌肌皮瓣重建相比有障碍。总之,与带蒂胸大肌肌皮瓣重建相比,DPAP游离皮瓣用于HNC软组织切除术后组织缺损的重建显着改善了患者的生活质量。
    We aimed to assess the quality of life for head and neck carcinoma (HNC) patients who underwent soft tissue resection and reconstruction with double-paddle peroneal artery perforator (DPAP) free flap. The quality of life was assessed by means of the University of Washington quality of life (UW-QOL) and the 14-item Oral Health Impact Profile (OHIP-14) questionnaires at 12 months postoperatively. Data from 57 patients were retrospectively analysed. Out of these, 51 patients were at TNM stage III or IV. Finally, 48 patients finished and returned the two questionnaires. In the UW-QOL questionnaire, the mean (SD) higher scores were pain 76.5 (6.4), shoulder 74.3 (9.6), and activity 71.6 (6.1), whereas the lower scores were chewing 49.7 (5.2), taste 51.1 (7.7), and saliva (56.7 (7.4). In the OHIP-14 questionnaire, the higher-scoring domains were psychological discomfort (69.3 (9.6) and psychological disability 65.2 (5.8), whereas the lower-scoring domains were handicap 28.7 (4.3) and physical pain 30.4 (8.1). The DPAP free flap significantly improved appearance, activity, shoulder, mood, psychological discomfort, and handicap compared with pedicled pectoralis major myocutaneous flap reconstruction. In conclusion, DPAP free flap for reconstruction of tissue defects after soft tissue resection of HNC significantly improved the patients\' QOL compared to pedicled pectoralis major myocutaneous flap reconstruction.
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