关键词: 舌鳞癌, 皮瓣, 手术, 吞咽

Abstract: PURPOSE: To investigate the changes of swallowing function in 40 patients with tongue squamous cell carcinoma undergoing radical resection and simultaneous repair and reconstruction 1 year after operation, to find the best swallowing rehabilitation opportunity for patients, and to provide targeted swallowing function guidance for patients. METHODS: The swallowing function of 40 cases of tongue squamous cell carcinoma undergoing simultaneous reconstructive surgery before (S0), 7 days to 10 days (S1), 3 months (S2), 6 months (S3), and 12 months (S4) after surgery were tested by the special evaluation method of swallowing function such as water swallowing test (WST) and the functional oral intake scale (FOIS). The data were analyzed using GraphPad Prism 5.0 software packages. RESULTS: Postoperative deglutition and feeding function were poor, especially in stage S1, which decreased significantly, and in stage S2 and S3, which accumulated gradually. Except for some patients, stage S4 patients returned to the preoperative state. WST results showed that there wasn't significant difference in swallowing function between stage S3, S4 patients and stage S0 patients (P>0.05). FOIS results showed that there was no significant difference in feeding function between S4 stage patients and S0 stage patients (P>0.05). The recovery of the feeding function was 6 months later than that of the swallowing function. The recovery of swallowing and feeding ability of patients with T4 tumor was worse than that of patients with T2 and T3 in stage S4, and the difference was statistically significant(P<0.05). The recovery of feeding ability in stage S4 patients was better in patients without tongue root deficiency than those with tongue root deficiency, and the difference was statistically significant(P<0.05). Postoperatively, patients without radiotherapy or chemotherapy had a better recovery of feeding function in S4 than those with radiotherapy or chemotherapy, and the difference was statistically significant(P<0.05). CONCLUSIONS: Some patients had mild dysphagia before operation, and 3 to 6 months after operation is the best time for patients to recover their swallowing function. It is important to strengthen health education and swallowing rehabilitation training of T4 patients and patients with loss of tongue, radiotherapy, and chemotherapy.

Key words: Tongue squamous cell carcinoma, Flap, Operation, Swallow