Postoperative Functional Evaluation Of Tongue Reconstruction Using Different Types Of Tissue Flap After Tongue Cancer Resection

Objective By using different types of tissue flap after tongue cancer resection,the tongue function study was conducted to preliminarily discuss and evaluate the differences of tongue function after tongue reconstruction,so as to provide a reference for the individualized repair of clinical tongue cancer.Methods Sichuan province cancer hospital were retrospectively analyzed in head and neck surgery between September 2015 and October 2017 during the Forearm Flap(FAF)21 cases,Anterolateral Thigh Flap(ALTF)10 cases and 9 cases of Pectoralis major Myocutaneous Flap(PMMF)repair clinical data of 40 patients with tongue cancer treatment,And through the Carestream Vue Picture Archiving and Communication System,we can evaluation of CT or MRI images of maxillofac ial region,tongue movement function measurement,the measurement of tongue motion,barium and barium radiography,food chewable effic iency,and Hirose language score system to score the external shape,motion function,swallowing function,chewing function,and language function.The obtained data was processed by SPSS 16.0 statistical software.The counting data is denoted by n,and Fisher's exact probability method is used for comparison between groups.Quantitative data(?x ± s)said,quantitative data or level of group comparison between the Kruskal-Wallis H test,group as the result of the positive correlation analys is(binary c lassification variables using independent sample t-test,multiple classification variables using single factor analys is of variance),into the positive variables and interest in the group as a multiple linear regression analys is.The test level was p<0.05,and the difference was statistically significant.Results A total of 27 males and 13 females were included in the study,ranging from 24 to 78 years old,with an average age of 52.30±11.26 years old.6 cases of perioperative skin flap infection,5 cases of skin flap blood supply disorder,22 cases of systemic chemotherapy;25 patients underwent postoperative local radiotherapy.According to the 22 cases in the T2 stage of AJCC version 7 in 2010,8 cases in the T3 stage and 10 cases in the T4 stage.Fisher's exact probability method,according to the FAF,ALTF group and PMMF general data of three groups of patients only statistical differences in tumor T stage(?2 = 33.345,P< 0.001),while in the sex,operation time,postoperative skin flap infection and skin flap blood disorders,and postoperative radiotherapy evaluation time differences have no statistical significance(P> 0.05).Kruskal Wallis H-test showed that only the tongue movement score between the three groups(H = 11.855,P = 0.003)and language score(H = 8.295,P = 0.016)difference is statistically significant,repair methods are sports scores and the influence factors of language score.Tukey test is adopted to improve the contrast analysis between groups,FAF on sports scores than PMMF group scored an average of 2.254 points higher,the difference was statistically significant(P = 0.040),while ALTF group scored an average of 4.211 points higher than that of PMMF group,difference was statistically significant(P = 0.001),but the FAF and ALTF group no significant difference between the two.In terms of language score,the language score of ALTF group was 0.36 points higher than that of PMMF group on average(P =0.015),and there was no significant difference between the other groups.Multiple linear regression analysis was carried out for sports score and language score respectively by "Enter",indicating that the regression models of sports score and language score were not statistically significant.Further into line with ALTF or PMMF tongue reconstruction of T3,T4,data analysis,a total of 17 patients Kruskal Wallis H-examination showed T3 tongue cancer patients in postoperative tongue shape ratings and ratings,swallowing chewing on a grade,sports scores,and language are no significant difference between the two groups(P > 0.05),T4 patients with tongue cancer only ALTF and PMMF movement score differences between groups was statistically significant(P = 0.009).The sports score of regenerated tongue in ALTF group was 4.33 points higher than that of PMMF group on average(P< 0.05),and the repair method had a statistically significant effect on regenerated tongue movement score of T4 stage tongue cancer(P < 0.001).Conclusion 1.The resection of the tongue cancer tissue flap to repair reengineering tongue movement function and language function will due to choose different types of tissue flap have significant differences,repair methods are both common factors;2.In tongue reconstruction on the motor function recovery of forearm flap group is better than that of pectoralis major myocutaneous flap,femoral anterolateral flap group is better than that of pectoralis major myocutaneous flap group,but the forearm flap and femoral anterolateral flap group itself has no obvious difference between them.3.There was no significant difference in the postoperative effect between the forearm flap group and the anterior lateral femoral flap group in the speech function recovery of the regenerated tongue.4.In the surgical treatment of locally advanced tongue cancer,postoperative exercise and reengineering tongue tongue reconstruction with tissue flap type has bigger relations,adopted by the application of line femoral a nterolateral flap reconstruction movement function after surgery for tongue is better than that of the pectoralis major myocutaneous flap.