Postoperative oral function of oral cancer patients reconstructed with free tissue transfer

本研究的目的是通过客观评估和访谈的方法来评估游离前臂桡侧皮瓣重建口腔癌患者术后的咀嚼和发音障碍，并研究使用言语辅助器具对口腔癌患者软腭和口咽部外侧壁缺损修复的言语和咽功能的影响。咀嚼和狗食：43例正常人和27例患者作为实验对象。重建患者分为三组：第一组切除舌和口腔底；第二组切除软腭和口咽外侧壁；在第三组中，下颌骨被切除。通过访谈进行主观评价。采用三种不同的方法进行客观评价：ATP颗粒咀嚼分光光度检查、30ml水吞咽检查、果冻、颗粒剂、饼干摄食口腔喂养检查。结果表明：(1)在咀嚼功能方面，治疗组2、治疗组3、治疗组1的功能恢复程度依次较好；(2)在吞咽和吞咽方面，第3组、第2组、第1组依次获得。结果提示，术后口腔功能的评价需要采用面谈和客观检查相结合的综合评价方法。言语功能：结果表明，使用言语辅助器具修复口咽软腭及外侧壁缺损的患者，可有效改善口咽功能及言语清晰度。

The Purpose of this study was to assess the postoperative mastication and dyglution of oral cancer patients reconstructed with free radial forearm flap using objective assessment and interview, and the effects of using a speech aid appliance on speech and velopharyngeal function were studied in oral cancer ratients in whom free flaps were used to repair defects of the soft palate and lateral wall of the oropharynx.1. Mastication and doglation :Forty-three normal individuals and twenty-seven patients served as subjects. Reconstructed patients were categorized into three groups : in the first group, the tongue and floor of the mouth were resected ; in the second group, the soft palate and lateral wall of the oropharynx were resected ; and in the third group, the mandible was resected. Subjective asessment was carried out by interview. Objective assessment was carried out by three defferent methods : the spectrophtometric examination of mastication using ATP particle, the swallowing examination of swallowing using 30ml water, and the oral feeding examination of ingestion using jelly, grule and cracker.The results indicated that : (1) in mastication, the functional recovery was obtained by Group 2, Group 3, and Group 1 in that order ; (2) in deglutition and lngestion, it obtained by Group 3, Group 2, and Group 1 in that order. The findings seem to indicate that composite assessment methods (interview and objective examination) are needed in assessment of postoperative oral function.2. Speech function :The results indicated that prosthodontic treatment using a speech aid appliance was effective in improving velopharyngeal function and speech intelligibility in patients in whom defects of the soft palate and lateral wall of the oropharynx were reconstructed with free flaps.