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  • Title: [Clinical application of free thoracoacromial artery perforator flap in reconstruction of tongue and mouth floor defects after resection of tongue carcinoma].
    Author: Song D, Li Z, Zhou X, Zhang Y, Xie S, Peng X, Zhou B, Lü C, Yang L, Peng W.
    Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2017 Feb 15; 31(2):222-226. PubMed ID: 29786257.
    Abstract:
    OBJECTIVE: To investigate the clinical outcome of free thoracoacromial artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma. METHODS: Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T 4N 0M 0, 3 cases as T 4N lM 0, 2 cases as T 3N 1M 0, 2 cases as T 3N 2M 0, and 1 case as T 3N 0M 0. The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average). RESULTS: All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal. CONCLUSION: The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results. 目的: 探讨游离胸肩峰动脉穿支皮瓣修复舌癌术后缺损的疗效。. 方法: 2010 年 5 月—2015 年 2 月，采用游离胸肩峰动脉穿支皮瓣移植修复 11 例舌癌术后缺损并行舌再造。男 9 例，女 2 例；年龄 33～72 岁，平均 52.6 岁。均为鳞状细胞癌；原发舌缘 7 例，原发舌腹 2 例，口底癌累及舌 2 例。根据国际抗癌联盟（UICC）TNM 分期：T 4N 0M 0 3 例，T 4N lM 0 3 例，T 3N 1M 0 2 例，T 3N 2M 0 2 例，T 3N 0M 0 1 例。病程 3～28 个月，平均 10.6 个月。肿瘤范围 6 cm×3 cm～10 cm×5 cm。术中穿支皮瓣切取范围为 7.0 cm×4.0 cm～11.0 cm×5.5 cm；厚度 0.6～1.2 cm，平均 0.8 cm；血管蒂长 6.8～9.9 cm，平均 7.2 cm。. 结果: 术后 11 例皮瓣均顺利成活，创面Ⅰ期愈合；供区切口均Ⅰ期愈合。患者均获随访，随访时间 12～24 个月，平均 17.2 个月。患者再造舌外形良好，吞咽及语言功能满意，随访期间肿瘤局部无复发。供区仅遗留线性瘢痕，胸大肌功能未见明显影响。. 结论: 胸肩峰动脉穿支皮瓣质地好，再造舌外形及功能良好，供区损伤小，是舌癌术后舌缺损修复与舌再造的理想选择。.
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