带神经再支配的游离股薄肌肌瓣用于动态舌重建

文献信息

中文摘要

背景： 在本中心，游离皮瓣重建是肿瘤指征下部分或全舌切除术后重建的金标准。在显微血管重建外科中，选择皮瓣时必须考虑多个因素。在缺乏完全满足所有要求的皮瓣时，我们力求恢复对生活质量影响最大的功能。舌的切除会导致言语、吞咽和味觉感受的显著损害。含有神经再支配肌肉的游离皮瓣可能适合恢复部分舌运动。方法：本报告介绍在部分舌切除术后使用带神经再支配的股薄肌肌皮游离皮瓣。在游离组织移植过程中，通过显微外科技术将取自身体另一部位的组织块连同其供应的微血管和神经一并移植。结果：除我们的标准术后管理方案外，皮瓣愈合顺利，术后第28天完全恢复经口进食。术后8个月拍摄的图像和吞咽X线片显示新舌呈颅尾方向运动。结论：这是匈牙利文献中该方法的首次报告。移植肌瓣的动态运动和体积保持可能防止功能丧失，从而对治疗后的生活质量产生积极影响。Orv Hetil. 2026; 167(44): 1785-1789。

英文摘要

At our center, free flap reconstruction is the gold standard after subtotal or total glossectomy performed for oncological indications. In microvascular reconstructive surgery, several factors must be considered when selecting a flap. In the absence of a flap that meets all requirements perfectly, we strive to restore the functions that most significantly affect the quality of life. Removal of the tongue causes significant impairment of speech, swallowing, and taste sensation. A free flap containing a reinnervated muscle may be suitable for restoring partial tongue movements. Our report presents the use of a reinnervated gracilis musculocutaneous free flap following subtotal glossectomy. During free tissue transplantation, a tissue block removed from another part of the body is transplanted along with its supplying microvessels and nerves using microsurgical techniques. In addition to our standard postoperative management protocol, the flap healed uneventful, and oral feeding was fully restored on the 28th postoperative day. Images and swallowing X-ray taken 8 months postoperatively show the neotongue moving in a cranio-caudal direction. This is the first report of this method in the Hungarian literature. The dynamic movement and volume preservation of the transplanted muscle flap may prevent functional loss, thereby positively affecting the quality of life after treatment. Orv Hetil. 2026; 167(44): 1785-1789.