Опухоли головы и шеи. 2023; 13: 32-42
Качество жизни больных раком языка после гемиглоссэктомии
https://doi.org/10.17650/2222-1468-2023-13-3-32-42Аннотация
Введение. Основную часть всех злокачественных новообразований полости рта составляет рак языка, основным методом лечения которого является операция. хирургическое лечение приводит к нарушению таких важных функций, как речь и глотание, что снижает качество жизни пациентов. Однако на сегодняшний день единого мнения относительно целесообразности выполнения реконструкции языка нет. К тому же не существует четких показаний для использования того или иного вида замещения дефекта, с помощью которого можно достичь наилучших функциональных результатов.
Цель исследования – оценить функциональные результаты после гемиглоссэктомии по поводу злокачественных новообразований языка, сравнить различные стратегии реконструкции (с использованием лоскута и без него).
Материалы и методы. В исследование включены 44 пациента с раком языка с периодом наблюдения не менее 6 мес. функциональные результаты проанализированы с помощью опросника качества жизни и логопедической оценки.
Результаты. пациенты, которым выполнялась реконструкция языка, имели более высокие функциональные результаты и лучшие показатели качества жизни по сравнению с пациентами, которым она не проводилась.
Заключение. Выполнение гемиглоссэктомии приводит к нарушению функций речи и глотания и, соответственно, к снижению качества жизни. поскольку выполнение реконструкции влияет на функциональные результаты, она должна быть надлежащим образом спланирована перед операцией.
Список литературы
1. Tagliabue M., Belloni P., De Berardinis R. et al. A systematic review and meta-analysis of the prognostic role of age in oral tongue cancer. Cancer Med 2021;10(8):2566–78. DOI: 10.1002/cam4.3795
2. Jahanbani J., Ghotbi M., Shahsavari F. et al. Selective anticancer activity of superparamagnetic iron oxide nanoparticles (SPIONs) against oral tongue cancer using in vitro methods: the key role of oxidative stress on cancerous mitochondria. J Biochem Mol Toxicol 2020;34(10):e22557. DOI: 10.1002/jbt.22557
3. Bakshi J., Goyal A.K., Saini J. Quality of life in oral cancer patients following surgical excision and flap reconstruction. J Maxillofac Oral Surg 2022;21(2):316–31. DOI: 10.1007/s12663-020-01499-5
4. Gabriele M., Michael G., Giulia M. et al. Quality of life, swallowing and speech outcomes after oncological treatment for mobile tongue carcinoma. Eur J Plast Surg 2020;43:247–56. DOI: 10.1007/s00238-019-01593-z
5. Yi C.R., Jeong W.S., Oh T.S. et al. Analysis of speech and functional outcomes in tongue reconstruction after hemiglossectomy. J Reconstr Microsurg 2020;36(7):507–13. DOI: 10.1055/s-0040-1709493
6. Chang E.I., Yu P., Skoracki R.J. et al. Comprehensive analysis of functional outcomes and survival after microvascular reconstruction of glossectomy defects. Ann Surg Oncol 2015;22(9):3061–9. DOI: 10.1245/s10434-015-4386-6
7. Bressmann T., Sader R., Whitehill T.L., Samman N. Consonant intelligibility and tongue motility in patients with partial glossectomy. J Oral Maxillofac Surg 2004;62(3):298–303. DOI: 10.1016/j.joms.2003.04.017
8. Li X., Sun Q., Guo S. Functional assessment in patients undergoing radial forearm flap following hemiglossectomy. J Craniofacial Surg 2016;27(2):e172–5. DOI: 10.1097/SCS.0000000000002261
9. Takatsu J., Hanai N., Suzuki H. et al. Phonologic and acoustic analysis of speech following glossectomy and the effect of rehabilitation on speech outcomes. J Oral Maxillofac Surg 2017;75(7):1530–41. DOI: 10.1016/j.joms.2016.12.004
10. Mannelli G., Arcuri F., Agostini T. et al. Classification of tongue cancer resection and treatment algorithm. J Surg Oncol 2018;117(5):1092–9. DOI: 10.1002/jso.24991
11. Kansy K., Mueller A.A., Mücke T. et al. A worldwide comparison of the management of surgical treatment of advanced oral cancer. J Craniomaxillof Surg 2018;46(3):511–20. DOI: 10.1016/j.jcms.2017.12.031
12. Hsiao H.T., Leu Y.S., Lin C.C. Primary closure versus radial forearm flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech. Ann Plast Surg 2002;49(6):612–6. DOI: 10.1097/00000637-200212000-00010
13. Chuanjun C., Zhiyuan Z., Shaopu G. et al. Speech after partial glossectomy: a comparison between reconstruction and nonreconstruction patients. J Oral Maxillofac Surg 2002;60(4):404–7. DOI: 10.1053/joms.2002.31228
14. Ji J.B., Cho Y.H., Song C.M. et al. Long-term functional outcomes after resection of tongue cancer: determining the optimal reconstruction method. Eur Arch Otorhinolaryngol 2017;274(10):3751–6. DOI: 10.1007/s00405-017-4683-8
15. Riva G., Sapino S., Ravera M. et al. Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas. Braz J Otorhinolaryngol 2022;4(Supple 4):S33–43. DOI: 10.1016/j.bjorl.2021.06.009
16. Lee D.Y., Ryu Y.J., Hah J.H. et al. Long-term subjective tongue function after partial glossectomy. J Oral Rehabil 2014;41(10):754–8. DOI: 10.1111/joor.12193
17. Shin Y.S., Kob Y.W., Kim S.H. et al. Radio-therapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg 2012;70(1):216–20. DOI: 10.1016/j.joms.2011.04.014
18. Furia C.L., Kowalski L.P., Latorre M.R. et al. Speech intelligibility after glossectomy and speech rehabilitation. Arch Otolaryngol Head Neck Surg 2001;127(7):877–83.
19. Dziegielewski P.T., Ho M.L., Rieger J. et al. Total glossectomy with laryngeal preservation and free flap reconstruction: objective functional outcomes and systematic review of the literature. Laryngoscope 2013;123(1):140–5. DOI: 10.1002/lary.23505
Head and Neck Tumors (HNT). 2023; 13: 32-42
Quality of life of patients with tongue cancer after hemiglossectomy
https://doi.org/10.17650/2222-1468-2023-13-3-32-42Abstract
Introduction. The main part among all malignant neoplasms of the oral cavity is tongue cancer, the leading method of treatment of which is surgery. Surgical treatment leads to a violation of such important functions of the language as speech and swallowing, which in turn reduces the quality of life of patients. However, to date, opinions differ on the issue of performing language reconstruction. In addition, there are no clear indications for the use of one or another type of defect replacement, with the help of which it will be possible to achieve the best functional results.
Aim. To evaluate the functional results after hemiglossectomy for malignant neoplasms of the tongue, compare various reconstruction strategies (with and without a flap).
Materials and methods. The study included 44 patients with tongue cancer with a follow-up period of at least 6 months. Functional results were assessed using a quality of life questionnaire and speech therapy assessment.
Results. Patients who underwent tongue reconstruction had higher functional results and the best indicators of quality of life compared to patients who did not undergo reconstruction.
Conclusion. Hemiglossectomy leads to impaired speech and swallowing functions and, accordingly, to a decrease in the quality of life. Since performing the reconstruction affects the functional results, it should be properly planned before the operation.
References
1. Tagliabue M., Belloni P., De Berardinis R. et al. A systematic review and meta-analysis of the prognostic role of age in oral tongue cancer. Cancer Med 2021;10(8):2566–78. DOI: 10.1002/cam4.3795
2. Jahanbani J., Ghotbi M., Shahsavari F. et al. Selective anticancer activity of superparamagnetic iron oxide nanoparticles (SPIONs) against oral tongue cancer using in vitro methods: the key role of oxidative stress on cancerous mitochondria. J Biochem Mol Toxicol 2020;34(10):e22557. DOI: 10.1002/jbt.22557
3. Bakshi J., Goyal A.K., Saini J. Quality of life in oral cancer patients following surgical excision and flap reconstruction. J Maxillofac Oral Surg 2022;21(2):316–31. DOI: 10.1007/s12663-020-01499-5
4. Gabriele M., Michael G., Giulia M. et al. Quality of life, swallowing and speech outcomes after oncological treatment for mobile tongue carcinoma. Eur J Plast Surg 2020;43:247–56. DOI: 10.1007/s00238-019-01593-z
5. Yi C.R., Jeong W.S., Oh T.S. et al. Analysis of speech and functional outcomes in tongue reconstruction after hemiglossectomy. J Reconstr Microsurg 2020;36(7):507–13. DOI: 10.1055/s-0040-1709493
6. Chang E.I., Yu P., Skoracki R.J. et al. Comprehensive analysis of functional outcomes and survival after microvascular reconstruction of glossectomy defects. Ann Surg Oncol 2015;22(9):3061–9. DOI: 10.1245/s10434-015-4386-6
7. Bressmann T., Sader R., Whitehill T.L., Samman N. Consonant intelligibility and tongue motility in patients with partial glossectomy. J Oral Maxillofac Surg 2004;62(3):298–303. DOI: 10.1016/j.joms.2003.04.017
8. Li X., Sun Q., Guo S. Functional assessment in patients undergoing radial forearm flap following hemiglossectomy. J Craniofacial Surg 2016;27(2):e172–5. DOI: 10.1097/SCS.0000000000002261
9. Takatsu J., Hanai N., Suzuki H. et al. Phonologic and acoustic analysis of speech following glossectomy and the effect of rehabilitation on speech outcomes. J Oral Maxillofac Surg 2017;75(7):1530–41. DOI: 10.1016/j.joms.2016.12.004
10. Mannelli G., Arcuri F., Agostini T. et al. Classification of tongue cancer resection and treatment algorithm. J Surg Oncol 2018;117(5):1092–9. DOI: 10.1002/jso.24991
11. Kansy K., Mueller A.A., Mücke T. et al. A worldwide comparison of the management of surgical treatment of advanced oral cancer. J Craniomaxillof Surg 2018;46(3):511–20. DOI: 10.1016/j.jcms.2017.12.031
12. Hsiao H.T., Leu Y.S., Lin C.C. Primary closure versus radial forearm flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech. Ann Plast Surg 2002;49(6):612–6. DOI: 10.1097/00000637-200212000-00010
13. Chuanjun C., Zhiyuan Z., Shaopu G. et al. Speech after partial glossectomy: a comparison between reconstruction and nonreconstruction patients. J Oral Maxillofac Surg 2002;60(4):404–7. DOI: 10.1053/joms.2002.31228
14. Ji J.B., Cho Y.H., Song C.M. et al. Long-term functional outcomes after resection of tongue cancer: determining the optimal reconstruction method. Eur Arch Otorhinolaryngol 2017;274(10):3751–6. DOI: 10.1007/s00405-017-4683-8
15. Riva G., Sapino S., Ravera M. et al. Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas. Braz J Otorhinolaryngol 2022;4(Supple 4):S33–43. DOI: 10.1016/j.bjorl.2021.06.009
16. Lee D.Y., Ryu Y.J., Hah J.H. et al. Long-term subjective tongue function after partial glossectomy. J Oral Rehabil 2014;41(10):754–8. DOI: 10.1111/joor.12193
17. Shin Y.S., Kob Y.W., Kim S.H. et al. Radio-therapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg 2012;70(1):216–20. DOI: 10.1016/j.joms.2011.04.014
18. Furia C.L., Kowalski L.P., Latorre M.R. et al. Speech intelligibility after glossectomy and speech rehabilitation. Arch Otolaryngol Head Neck Surg 2001;127(7):877–83.
19. Dziegielewski P.T., Ho M.L., Rieger J. et al. Total glossectomy with laryngeal preservation and free flap reconstruction: objective functional outcomes and systematic review of the literature. Laryngoscope 2013;123(1):140–5. DOI: 10.1002/lary.23505
