The Function Of Tongue Flaps In The Reconstruction Of Partial Resection Of Larynx And Hypopharynx

Objective:To investigate the function of tongue flaps in repairing the defect of partial resection ofthe laryngeal and hypopharyngeal carcinoma and to evaluate laryngeal functional recovery ofbreathing, swallowing and pronouncing by using tongue flaps to reconstruction of partialresection and to improve the postoperative therapy effect.Method:In this research, by retrospective analyses we collected31clinical cases betweenJanuary2004and December2011from the department of otolaryngology in second hospital ofJilin University which have been used all kinds of tongue flaps to repair the postoperativedefects of laryngeal and hypoparyngeal carcinoma. We evaluated laryngeal functionalrecovery of breathing, swallowing and pronouncing based on the surgical approach，leisionlocation，pathology，lymph nodes metastasis and whether or not breathing with tracheostomycannula, dysphagia and the degree of aspiration and hoarseness to disscuss therelationship between the repairing method and the postoperative therapy effect.Result:According to the growth range and spread degree of carcinoma, we classified31clinicalcases according to UICC’s TNM standard. The result as follows: piriform fossa carcinoma（26cases）, including T₂N₀M₀2cases，T₂N₁M₀7cases，T₃N₀M₀2cases, T₃N₁M₀7cases, T₃N₂M₀4cases, T₄N₁M₀2cases, T₄N₂M0₂cases, supraglottic carcinoma（2cases）, including T₄N₁M₀1case and T₃N₀M₀1case，glottic carcinoma T₄N₂M₀（2cases） and laryngeal cancerrecurrence（1case）. The pathology of all the cases were squamous cell carcinoma. There werethree types of tongue flaps applied for these31cases：including27cases of which applied bythe tongue flap of base of tongue,4cases of which were repaired by the sternohyoid myofascial resection;3cases of which were the half tongue flap of base of tongue,1cases ofwhich was the base of tongue flap having a pedicle in one side. All these tongue flapssurvived in31cases and the incision heals well. Most of the31patients had no difficulties inswallowing,some people had some difficulties in swallowing,but they could recocer afterthey had been taught in a short time. Except1patient who had recurred in postoperation had asmall difficulty in communication,there were no dysfunction obviously of communication.Five patients could breath very well when tracheal tubes were removed and five patientscould breath well when tubes were blocked.Conclusion:It is satisfactory of clinical effect by applying tongue flaps to repair the defect of laryngealand hypopharyngeal carcinoma. We could design all kinds of tongue flaps according to thedefect of hypopharynx soft tissues’ size and location. There are several advantages includingthat easily to be obtained, little damage for the tissue, short of time for operation,conveniencely to be finished, with adequate blood supplement,easily to survive and rarelypostoperative complications when using tongue flaps to repair large defects of the pharynxfollowing subtotal laryngopharyngectomy. It is a good therepy method to repaire the throatfront wall，throat before the wall and throat pharynx wall which can be used widely for thepatients to improve the postoperative clinical effect.