설결손의 재건 후 기능적 예측 인자의 분석

Abstract

Purpose: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function.

Method: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months.

Results: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance.

Conclusions: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.