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

本研究的目的是通过客观评价和访谈法评价前臂游离皮瓣修复口腔癌术后患者的咀嚼功能和咀嚼功能障碍，并对口腔癌患者在应用游离前臂皮瓣修复软腭部和口咽侧壁缺损时使用语音辅助器对语音和腭咽闭合功能的影响进行研究。咀嚼与拖拽：以43名正常人和27名患者为研究对象。重建术分为三组：第一组切除舌体和口底，第二组切除软腭部和口咽外侧壁，第三组切除下颌骨。采用访谈法进行主观评价。结果表明：(1)咀嚼功能恢复依次为第2组、第3组、第1组；在吞咽、吞咽方面，依次为第3组、第2组、第1组。结论：1.术后口腔功能评价需要综合评价方法(访谈法和客观测验法)。语音功能：结果表明，应用语音辅助矫治器修复软腭部及口咽侧壁缺损的患者，可有效改善腭咽闭合功能，提高语音清晰度。

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.