血管化黏膜瓣在早-中期舌癌及口底癌缺损修复中的早期应用研究  

Application of vascularized mucosal flap for early-medium-term tongue cancer and floor of mouth cancer defect repair:a preliminary study

作　　者：蒋悦赟 唐菱菱 马中凯 刘伟 黄能文 李春洁[1] Jiang Yueyun;Tang Lingling;Ma Zhongkai;Liu Wei;Huang Nengwen;Li Chunjie(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Head and Neck Oncology,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;Dept.of Oral and Maxillofacial Surgery,People,s Hospital of Anshun City,Anshun 561000,China)

机构地区：[1]口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院头颈肿瘤外科,成都610041 [2]安顺市人民医院口腔颌面外科,安顺561000

出　　处：《华西口腔医学杂志》2022年第2期204-209,共6页West China Journal of Stomatology

基　　金：国家自然科学基金(U1813213);四川省科学技术厅项目(2021YJ0129,2019YFS0362)。

摘　　要：目的探究以面动脉为蒂的黏膜肌(FAMM)瓣在修复临床早-中期舌癌及口底癌缺损中的临床效果及安全性。方法通过回顾性队列研究的方式纳入使用FAMM瓣(FAMM组)或者皮瓣(皮瓣组)修复早-中期舌癌、口底癌切除后中小型舌、口底缺损的患者,收集患者一般资料及相关手术资料,术后3个月和6个月评估患者满意度、张口度、外形满意度、语音满意度以及进食功能情况。结果本研究共纳入患者45名,其中FAMM组15名,皮瓣组30名。所有患者均完成了术后3个月随访,2组各1名患者在术后6个月失访,随访到的患者没有复发及转移征象。FAMM组手术时间短于皮瓣组(P<0.05)。皮瓣组患者术后供瓣区不适多于FAMM组(P<0.05)。2组患者术后总体满意度差异无统计学意义(P>0.05),但FAMM组术后6个月外形满意度、语音满意度和进食功能优于皮瓣组(P<0.05);术后3个月张口度FAMM组小于皮瓣组(P<0.05),但术后6个月2组差异无统计学意义(P>0.05)。结论FAMM瓣修复早-中期舌、口底癌切除后中小型的舌、口底缺损具有一定的优势,可以在临床中考虑使用。Objective This study aimed to assess the efficacy and safety of facial artery musculomucosal(FAMM)flap for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer.Methods A retrospective cohort study was conducted and included patients with early-medium stage tongue or floor of mouth cancer and reconstructed by FAMM flap or traditional free or axial flaps.Demographic data and surgery-related data were collected.Patients were followed up for 6 months and evaluated with satisfaction,maximal mouth opening,satisfactory contour and speech,and oral intake function at months 3 and 6.Results Forty-five patients were included,with 15 in the FAMM group and 30 in the flap group.All patients finished 3 months followup,and 1 in each group was lost to follow-up at month 6.All followed-up patients had no recurrence or metastasis.The FAMM group had a significantly shorter surgical time than the flap group(P<0.05).The flap group had significantly more donor sites that were uncomfortable compared with the FAMM group(P<0.05).There was no statistical significance on satisfaction,but the FAMM group had better outcomes on contour,speech,and oral intake function at month 6 than the flap group(P<0.05).The FAMM group had smaller maximal mouth opening than the flap group(P<0.05)at month 3 but equivalent maximal mouth opening at month 6(P>0.05).Conclusion FAMM flap has some advantages for small-medium tongue or floor of mouth defects caused by surgical resection of early-medium stage tongue or floor of mouth cancer,and it could be an ideal choice for clinical application.

关 键 词：以面动脉为蒂的黏膜肌瓣 修复重建外科 口腔颌面缺损 舌癌 口底癌 

分 类 号：R739.8[医药卫生—肿瘤]