舌癌根治同期前臂游离皮瓣或直接缝合修复半舌缺损的语音功能评价

目的 探讨舌癌根治术同期以前臂游离皮瓣或直接缝合修复半舌缺损对术后语音功能恢复的影响.方法 选取接受常规舌癌根治术患者36例,其中16例行纵向半侧舌体切除后直接拉拢缝合,20例半侧舌体切除后以前臂游离皮瓣修复.于术后6个月,比较两组语音清晰度的差异;VS-9700语音工作站对患者/ji/的发音进行语音频谱分析.结果 ①前臂游离皮瓣修复组患者语音清晰度高于直接拉拢缝合组,两组之间差异有统计学意义(P＜0.05).②直接拉拢缝合组患者/ji/音元音第1共振峰值低于对照组、第2共振峰值高于对照组,两组之间差异有统计学意义(P＜0.05).前臂皮瓣修复组患者/ji/音元音第1共振峰值低于对照组,两组之间差异有统计学意义(P＜0.05),第2共振峰值与对照组差异无统计学意义(P＞0.05).结论 应用前臂游离皮瓣修复半舌缺损可改善患者术后语音功能.

Evaluation of the articulator function in the hemi-tongue defect patients after radical tongue cancer resection and simultaneous reconstruction with forearm flap or primary close

OBJECTIVE: To explore the effect of the patients' articulator function after reconstruction of hemi-tongue defect with forearm flap (FAP) or prime clsoe (PC). METHODS: 36 patients who underwent hemiglossectomy were investigated after radical surgery for TSCC. 20 cases were reconstructed with FAP flaps and 16 with primary closure. The patients' articulator functions were evaluated by articulation tests. VS-9700 was used to analyze the speech character when they pronounce /ji/. RESULTS: 1) The speech articulation of patients who underwent hemi-tongue reconstruction with FAF was better than that of patients with PC, and there was significant difference between them (P < 0.05). 2) The first formant (F1) of /i/ of the PC group was lower than that of the control group (P < 0.05). But the second formant (F2) of the PC group was higher than that of the control group (P < 0.05). The first formant (F1) of /i/ of the FAF group was lower than that of the control group (P < 0.05), but there were no significant differences between FAF group and control group in F2 of /i/ (P > 0.05). CONCLUSIONS: Articulator function can be well achieved by forearm flaps reconstruction to hemi-tongue defect patients.