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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Voice outcomes following reconstruction of laryngopharyngectomy defects using the radial forearm free flap and the anterolateral thigh free flap
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Voice outcomes following reconstruction of laryngopharyngectomy defects using the radial forearm free flap and the anterolateral thigh free flap

机译：free骨前臂游离皮瓣和大腿前外侧游离皮瓣修复喉咽切除术缺损后的声音结果

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Objectives/Hypothesis Patients undergoing laryngopharyngectomy with extensive pharyngeal mucosal resection or those failing chemoradiation protocols are commonly reconstructed using free tissue transfer. Radial forearm free flaps (RFFFs) and anterolateral thigh free flaps (ALTs) are two of the most commonly used free flaps for laryngopharyngectomy reconstruction. It has been suggested that alaryngeal tracheoesophageal prosthesis (TEP) speech outcomes in patients undergoing ALT reconstruction may be inferior due to the possibly bulkier neopharynx. We report the results of patients treated with ALT and RFFF with regard to postoperative TEP voice outcomes. Study Design Retrospective cohort study. Methods We identified 42 consecutive patients who were treated with total laryngopharyngectomy and free flap reconstruction utilizing either RFFFs (20 patients) or ALTs (22 patients) between April 2001 and August 2010. Evaluations with statistical analysis of standard TEP speech outcome measures (maximal sustained phonation, fluent count, syllable count) and qualitative variables were conducted. Results Patient demographics were similar between the RFFF and ALT groups, and 95% and 91% of RFFF and ALT patients received radiation therapy, respectively. Subjective voice quality did not significantly differ between the groups. Differences in outcomes of intelligibility, maximal sustained phonation time, maximum number of syllables, and fluent count, as evaluated by a single speech pathologist, were not statistically significant between RFFF and ALT patients. There was no difference in postoperative complications. Conclusions These data indicate that reconstruction of laryngopharyngectomy defects using either the ALT or RFFF technique can produce similarly acceptable TEP voice results. Level of Evidence: 2b.
机译：目的/假说接受喉咽切除术并进行广泛的咽粘膜切除术或化学放疗方案失败的患者通常使用自由组织转移来重建。前臂游离皮瓣（RFFFs）和大腿前外侧游离皮瓣（ALTs）是喉咽切除术重建最常用的两种游离皮瓣。有人建议，由于可能的鼻咽肿大，进行ALT重建的患者的咽喉气管食管假体（TEP）语音结局可能较差。我们报告了接受ALT和RFFF治疗的患者术后TEP语音结局的结果。研究设计回顾性队列研究。方法我们确定了2001年4月至2010年8月之间使用RFFF（20例患者）或ALT（22例患者）进行全喉咽喉切除术和游离皮瓣重建治疗的42例连续患者。对标准TEP言语预后量度（最大持续发声）的统计分析进行评估，流利计数，音节计数）和定性变量。结果RFFF和ALT组患者的人口统计学特征相似，分别接受放射治疗的RFFF和ALT患者分别为95％和91％。两组之间的主观语音质量没有显着差异。由单个言语病理学家评估的可理解度，最大持续发声时间，最大音节数和流利计数的结果差异在RFFF和ALT患者之间无统计学意义。术后并发症无差异。结论这些数据表明，使用ALT或RFFF技术重建喉咽切除术缺损可以产生类似的TEP语音结果。证据等级：2b。

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