透過您的圖書館登入
IP:34.205.2.207
  • 期刊

利用舌牽引術保留唇顎完整性來施行全舌切除

Pull-through Technique for a Total Glossectomy without Lip Splitting and a Mandibulotomy

摘要


The study analyzed 15 oral cancer patients for which either conventional mandibular-lip splitting or the pull-through technique was chosen to perform a total glossectomy, and surgical defects were reconstructed using anterolateral thigh flaps (ALTFs). Thirteen tongue cancers and 2 floor-of-the-mouth cancers were included and were pathologically diagnosed as stage Ⅳ squamous cell carcinomas. The surgical method was selected based on the extent of maximal mouth opening (MMO) to facilitate the mandibular lingual gingival incision. Ten cases with an MMO of≥15 mm were treated using the pull-through technique, whereas conventional mandibular-lip splitting was applied to the other 5 cases with an MMO of <15 mm. The 2 different methods were retrospectively compared according to clinical factors and postoperative complications. The success rates of the ALTFs were 100% for both groups. However, patients treated using the pull-through technique revealed shorter surgical time, less blood loss, a shorter hospital stay (p<0.001, p=0.022, p=0.004, respectively), a better facial appearance, and the same prognosis. Additionally, the pull-through group greatly outperformed the other one without postoperative complications. In contrast, 1 case each of flap infection, orocutaneous fistula, and lower incisor necrosis, and 2 cases of lingual tipping of the mandibular incisors with deepening of the periodontal pockets were found among the mandibular-lip splitting patients. To summarize, the pull-through technique can be expedient and widely used for a total or partial glossectomy as long as this technique is meticulously applied with suitable indications.

並列摘要


The study analyzed 15 oral cancer patients for which either conventional mandibular-lip splitting or the pull-through technique was chosen to perform a total glossectomy, and surgical defects were reconstructed using anterolateral thigh flaps (ALTFs). Thirteen tongue cancers and 2 floor-of-the-mouth cancers were included and were pathologically diagnosed as stage Ⅳ squamous cell carcinomas. The surgical method was selected based on the extent of maximal mouth opening (MMO) to facilitate the mandibular lingual gingival incision. Ten cases with an MMO of≥15 mm were treated using the pull-through technique, whereas conventional mandibular-lip splitting was applied to the other 5 cases with an MMO of <15 mm. The 2 different methods were retrospectively compared according to clinical factors and postoperative complications. The success rates of the ALTFs were 100% for both groups. However, patients treated using the pull-through technique revealed shorter surgical time, less blood loss, a shorter hospital stay (p<0.001, p=0.022, p=0.004, respectively), a better facial appearance, and the same prognosis. Additionally, the pull-through group greatly outperformed the other one without postoperative complications. In contrast, 1 case each of flap infection, orocutaneous fistula, and lower incisor necrosis, and 2 cases of lingual tipping of the mandibular incisors with deepening of the periodontal pockets were found among the mandibular-lip splitting patients. To summarize, the pull-through technique can be expedient and widely used for a total or partial glossectomy as long as this technique is meticulously applied with suitable indications.

延伸閱讀