A New Method for Treatment of Oral Cancer Postoperative Sialorrhea-Dermal Sling Operation

一種新的治療口腔癌術後唾液失禁的方法－“真皮吊帶術”

謝榮賢(Jung-Hsien Hsieh) ； 王健興(Chien-Hsing Wang) ； 洪學義(Shyue-Yih Horng) ； 陳明庭(Ming-Ting Chen)

《中華民國整形外科醫學會雜誌》 11卷2期 (2002/06) Pp. 86-93

https://doi.org/10.7096/JPSA.200206.0086

摘要

口腔癌術後常造成大量軟組織及骨頭的缺損，現在大多使用自由皮瓣來修補傷口。但口腔癌患者手術重建後仍有很多後遺症，包括了外觀問題、吞嚥困難、容易流口水等等。重建手術的目的漸漸由組織缺損修補轉變成外觀及功能的恢復。
易流口水是此類病人常見的後遺症，我們描述了“真皮吊帶術式”來治療這種後遺症。這種術式是利用皮瓣本身的真皮及其皮下組織來懸吊易流口水的嘴角。從1999年12月到2001年3月有78個口腔癌病人接受切除及重建，其中有11個產生易流口水的後遺症。我們應用這種術式於7個這類的病人，均得不錯的效果。

並列摘要

The treatment of oral cancer is mainly of operative resection. Due to huge extent of resection, reconstructive surgery is performed at the same time to cover soft/and or bony defect. The reconstruction method was mainly of pectoralis major myocutaneous pedicle flap, forehead flap, temporalis muscle flap, deltopectoral flap, and trapezius myocutaneous flap in the past. However, due to progress in microsurgical technique, the free flap becomes preferred reconstruction method recently.
Although advances in reconstruction surgery, there are still many sequelae to patients who received extensive surgery. These sequelae include poor outer appearance, and functional disturbance as dysphagia, impaired speech and drooling etc. The goal of reconstruction surgery has to consider wound closure, cosmesis, and preservation of function at the same time if possible.
The sialorrhea is one of the main post-operative sequelae to the patient. We have described a new ”dermal sling operation” to improve the post-operative sialorrhea. The ”dermal sling operation” uses a strip of de-epithelized tissue containing dermis and a portion of subcutaneous fat from the flap itself to suspend the mouth angle.
There were 78 patients suffered from oral cancer underwent wide excision of lesion and free flap reconstruction from December1999 to March 2001. Post-operative sialorrhea was noted in 11 patients. The ”dermal sling operation” was performed to treat the problem in 7 patients. The follow up period ranged from 3months to 19 months with good results.

並列關鍵字

dermal sling operation ； sialorrhea ； free flap reconstruction