A novel anatomy-based five-points eight-line-segments technique for precision subtotal tongue reconstruction: A pilot study
A novel anatomy-based five-points eight-line-segments technique for precision subtotal tongue reconstruction: A pilot study
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一种基于解剖学的新型五点八线段精确舌大部重建技术：一项试点研究
DOI：
10.1016/j.oraloncology.2018.12.004
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发表时间：
2019
期刊：
影响因子：
4.8
通讯作者：
Li Jinsong
中科院分区：
文献类型：
--
作者：
Fan Song;Zhang Hanqing;Li Qunxing;Liang Faya;Bai Zhiqiang;Chen Weixiong;Sun Sheng;Yu Peirong;Li Jinsong
目的 据报道，基于实际舌头解剖结构的无皮瓣设计可以实现精确重建，但大的癌性舌头缺陷的治疗仍然极具挑战性。本试验的目的是探索基于解剖学的皮瓣设计，用于精确舌大部重建。 材料和方法 将 35 例患者随机分为两组，“五点八线段”（FIPELS）技术皮瓣设计组（18 名患者）和传统手术组（17 名患者），进行舌大部重建。所有患者均接受了股前外侧皮瓣，神经与舌神经或舌咽神经接合。使用李克特量表评估吞咽功能、言语清晰度和美容结果，并研究新舌头的外在感受和本体感受敏感性以及热感觉。对结果进行分析，p 值<0.05 被认为是显着的。结果 FIPELS 皮瓣明显大于传统设计的皮瓣。除了两名出现部分坏死的患者外，所有皮瓣均顺利愈合。与传统组的患者相比，FIPELS 组的患者吞咽功能（p=0.043）和美容效果（p=0.017）显着改善，但言语清晰度没有改善（p=0.154）。两组患者的外视和本体感觉敏感性以及热感觉恢复情况相当。结论基于解剖学的 FIPELS 技术是舌次全重建的一种创新且有效的解决方案。
ObjectivesA no-flap design based on actual tongue anatomy has been reported to achieve precise reconstruction, but large carcinologic tongue defects remain extremely challenging to treat. The aim of this pilot study was to explore an anatomy-based flap design for precision subtotal tongue reconstruction.Material and methodsThirty-five patients were randomly divided into two groups, a “five-points eight-line-segments” (FIPELS) technique flap design group (18 patients) and a conventional surgery group (17 patients), to undergo subtotal tongue reconstruction. All patients received an anterolateral thigh flap with nerve coaptation to the lingual or glossopharyngeal nerve. Swallowing function, speech intelligibility, and cosmetic results were assessed with a Likert scale, and epicritic and proprioceptive sensitivity and thermosensation of the neotongue were investigated. Outcomes were analyzed, and a p-value < 0.05 was considered significant.ResultsThe FIPELS flaps were significantly larger than conventionally designed flaps. All flaps healed uneventfully, except in two patients who presented with partial necrosis. Relative to patients in the conventional group, patients in the FIPELS group showed significantly improved swallowing function (p = 0.043) and cosmetic results (p = 0.017) but not speech intelligibility (p = 0.154). Patients in the two groups recovered comparably in terms of epicritic and proprioceptive sensitivity and thermosensation.ConclusionThe anatomy-based FIPELS technique is an innovative and effective solution for subtotal tongue reconstruction.