@article{oai:niigata-u.repo.nii.ac.jp:00025675, author = {福西, 雅史 and 星名, 秀行 and 永田, 昌毅 and 長島, 克弘 and 藤田, 一 and 宮浦, 靖司 and 宮本, 猛 and 相馬, 陽 and 関, 雪絵 and 高木, 律男}, issue = {1}, journal = {新潟歯学会雑誌, 新潟歯学会雑誌}, month = {Jul}, note = {To estimate the survival rate and postoperative functions, we have evaluated the 30 cases (male: 27, female: 3, average: 56.6 years of age, ranged from 24 to 77 years f age) with oral cancer reconstructed with a pedicled or a free flap for 26 years from 1976 to 2001. The sites of involvement were the tongue in 13 cases and the oral floor in 17 cases. The postoperative articulation, mastication and swallowing were studied as oral functions. As results of investigation, 5-year cumulative survival rates were 69.2% in the tongue group and 81.4% in the oral floor group. Flaps survived completely in 26 (86.7%) cases, partial necrosis occurred in 4 (13.3%) cases, and no total necrosis took place. The postoperative oral functions were still remained in almost all cases which were applied the partial or hemiglossectomy or the resection of the lateral portion of the oral floor. However, the cases in resection of anterior portion of the oral floor had a little dysfunction, and many cases of the subtotal glossectomy revealed relative sever dysfunctions. As to occlusal function, it depends on the prothetic conditions to some degree. These results suggest that it is very important for high quality of life to select the appropriate resection and reconstruction, and furthermore, postoperative rehabilitation for swallowing and speech and prosthetic treatment for mastication are very important for not only morphologic reconstruction but also the postoperative oral functions., 1976年から2001年までの26年間に、有茎および遊離皮弁による一次再建手術を施行した舌痛13例、口底癌17例、計30例 (男性27例、女性3例。 24~77歳、平均56.6歳)について、治療成績および術後機能を評価した。術後機能は会話明瞭度、咀嚼機能、 嚥下機能の3項目について評価した。その結果、 5年累積生存率は舌痛69.2%、口底癌81.4%であった。また、皮弁の生者は、完全生者が26例(86.7%)、部分壊死が4例(13.3%)で、全部壊死はなかった。一方、術後機能については、舌部分切除例、口底側方切除例、舌口底半側切除例ともに、比較的良好に温存されていた。しかし、口底前方切除例では機能の低下がみられ、舌亜全摘例においては、重度の機能障害が残遺していた。さらに、咀嚼機能では歯の欠損もともなうため、補綴処置が不可能な場合には十分な機能回復が得られていなかった。以上より、適切な切除範囲の設定、再建方法の選択などがQOLの維持のために重要であり、さらに術後には嚥下および言語訓練などのリハビリテーションの実施、さらに咀嚼機能のための補綴的処置が形態の再建のみでなく口腔機能の回復において非常に重要であると思われた。}, pages = {15--21}, title = {舌癌、口底癌一次再建例の治療成績と術後機能}, volume = {33}, year = {2003} }