Archives of otolaryngology--head & neck surgery · 2009
Oropharyngoplasty with template-based reconstruction of oropharynx defects.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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История · было → стало
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Chepeha Douglas B, Sacco Assuntina G, Erickson Vanessa R, Lyden Teresa, Haxer Marc, Moyer Jeffrey, Teknos Theodoros N, Prince Mark E, Eisbruch Avraham, Bradford Carol R, Wolf Gregory T
Аннотация
OBJECTIVE: To determine if oropharyngoplasty using a Gehanno technique of superior constrictor velopharyngoplasty, base of tongue mounding, and primary hypopharyngeal closure in combination with template-based revascularized free tissue transfer is effective for reconstruction of the oropharyngeal defect.
DESIGN: Prospective case series.
SETTING: Tertiary care academic medical center.
PATIENTS: The study population comprised 25 patients (21 men and 4 women; mean age, 55.3 years) presenting from January 1998 to January 2001 with oropharyngeal squamous cell carcinoma. A comparison was performed based on the percentage of resection of the soft palate (group 1, < or =50% palate; group 2, >50% palate).
INTERVENTIONS: Of the 25 patients, 24 (96%) received radiotherapy. The donor sites were radial forearm for 23 of 25 patients (92%) and lateral arm for 2 of 25 patients (8%). The mean area was 92 cm(2) (range, 25-150 cm(2)), and the mean length of the velopharyngoplasty component of the oropharyngoplasty was 2.15 cm (range, 1-3 cm).
MAIN OUTCOME MEASURES: Gastrostomy tube dependence, major and minor complications, time to oral intake, speech and swallowing assessment, and quality-of-life assessment.
RESULTS: Of the 25 patients, 2 (8%) remain gastrostomy dependent; 6 (24%) developed major complications; and 7 (28%) developed minor complications. Speech in both groups 1 and 2 was considered understandable most of the time, with occasional repetition. The group 1 patient with a median assessment score could eat a solid diet without restriction of place or person, whereas the group 2 patient with a median assessment score could eat a soft, moist diet with selected persons in selected places.
CONCLUSION: Integration of oropharyngoplasty with template-based revascularized free tissue transfer produced speech results that were independent of palate defect size, and swallow function test results were similar to other published reconstructive techniques.
DESIGN: Prospective case series.
SETTING: Tertiary care academic medical center.
PATIENTS: The study population comprised 25 patients (21 men and 4 women; mean age, 55.3 years) presenting from January 1998 to January 2001 with oropharyngeal squamous cell carcinoma. A comparison was performed based on the percentage of resection of the soft palate (group 1, < or =50% palate; group 2, >50% palate).
INTERVENTIONS: Of the 25 patients, 24 (96%) received radiotherapy. The donor sites were radial forearm for 23 of 25 patients (92%) and lateral arm for 2 of 25 patients (8%). The mean area was 92 cm(2) (range, 25-150 cm(2)), and the mean length of the velopharyngoplasty component of the oropharyngoplasty was 2.15 cm (range, 1-3 cm).
MAIN OUTCOME MEASURES: Gastrostomy tube dependence, major and minor complications, time to oral intake, speech and swallowing assessment, and quality-of-life assessment.
RESULTS: Of the 25 patients, 2 (8%) remain gastrostomy dependent; 6 (24%) developed major complications; and 7 (28%) developed minor complications. Speech in both groups 1 and 2 was considered understandable most of the time, with occasional repetition. The group 1 patient with a median assessment score could eat a solid diet without restriction of place or person, whereas the group 2 patient with a median assessment score could eat a soft, moist diet with selected persons in selected places.
CONCLUSION: Integration of oropharyngoplasty with template-based revascularized free tissue transfer produced speech results that were independent of palate defect size, and swallow function test results were similar to other published reconstructive techniques.
Предметные рубрики MeSH
AdultAgedCarcinoma, Squamous CellFemaleFollow-Up StudiesGraft RejectionGraft SurvivalHumansMaleMicrocirculationMiddle AgedOropharyngeal NeoplasmsPostoperative ComplicationsProbabilityProspective StudiesQuality of LifePlastic Surgery ProceduresRisk AssessmentStatistics, NonparametricSurgical FlapsSurvival AnalysisTreatment Outcome