下颌骨截骨术位置对舌癌患者口腔功能的影响
Influence of mandibulotomy approaches on oral function following radical resection of tongue carcinoma
作者：吴建军, 高兴, 王文瑾, Aly Gomaa, 陈洁, 胡雅琴, 翦新春, 蒋灿华
Author：Wu Jianjun, Gao Xing, Wang Wenjin, Aly Gomaa, Chen Jie, Hu Yaqin, Jian Xinchun, Jiang Canhua
收稿日期：2019-08-04 年卷（期）页码：2020,38(3):280-280-283
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：下颌骨截骨术,正中,旁正中,口腔功能,
Key words：mandibulotomy,median,paramedian,oral function,
基金项目：国家自然科学基金青年基金(81703069);湖南省自然科学基金青年基金(2017JJ3493)
中文摘要
目的 比较正中或旁正中下颌骨截骨术对舌癌患者口腔功能的影响,为下颌骨截骨位置的选择提供依据。方法 回顾性分析经下颌骨截骨入路进行舌颌颈联合根治及缺损修复重建的126例舌癌患者的临床资料。根据截开下颌骨位置的不同,分为下颌骨正中截骨术组（正中组,n=60）和下颌骨旁正中截骨术组（旁正中组,n=66）。术后定期随访,应用华盛顿大学生存质量问卷（UW-QOL）第四版比较2组患者术后吞咽、咀嚼和语音等口腔功能的差异。采用SPSS 24.0软件包进行统计学处理,P<0.05为差异有统计学意义。结果 术后6月,正中组与旁正中组吞咽、咀嚼及语音功能评分差异均无统计学意义;术后1年,旁正中组患者吞咽和语音功能评分优于正中组（P<0.05）,但咀嚼功能评分差异无统计学意义。结论 经旁正中下颌骨截骨入路进行舌颌颈联合根治,术后患者口腔功能优于经正中下颌骨截骨入路。
英文摘要
ObjectiveThis study aimed to compare the influences of postoperative oral function in patients with median or paramedian mandibulotomy during the radical resection of tongue carcinoma and to provide evidence for the choice of osteotomy location for mandibulotomy.MethodsThe clinical data of 126 patients who underwent combined radical neck dissection with mandibulectomy and glossectomy followed by simultaneous reconstruction were analyzed retrospectively. The patients were divided into two groups according to the position of mandibulotomy: median mandibulotomy group (median group,n=60) and paramedian mandibulotomy group (paramedian group,n=66). The fourth edition of the University of Washington Quality of Life Questionnaire (UW-QOL) was used to compare the differences in oral functions, such as swallowing, mastication, and speech, between the two groups during regular follow-up. SPSS 24.0 software package was used for statistical analysis, andP<0 .05 was considered statistically significant.ResultsSix months after the operation, no significant differences in swallowing, mastication, and speech functions were found between the median and paramedian groups. However, the swallowing and speech functions in the paramedian group were better than those in the median group 1 year after the operation (P<0 .05), whereas no statistical difference in mastication function was observed between the two groups.ConclusionEvaluation of the postoperative oral function results showed that paramedian mandibulotomy was a better surgical approach than median mandibulotomy. Paramedian mandibulotomy is worth prioritizing in the radical resection of tongue carcinoma.
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