학술대회 발표 연제 초록

발표형식 : 구연채택 접수번호 - 990183    HNOP 1-1 
PROSPECTIVE ANALYSIS OF OBJECTIVE VOLUMETRIC RECONSTRUCTION OF GLOSSECTOMY DEFECTS AND ITS IMPACT ON SPEECH AND SWALLOWING OUTCOMES
DEP. OF HEAD-NECK SURGERY, MEDANTA-THE MEDICITY, GURGAON, INDIA
KARAN ., KARAN GUPTA, AKSHDEEP, ADITYA AGGARWAL, DEEPAK SARIN
목적: Traditional predictions of functional and quality of life outcomes following free flap reconstruction for glossectomy defect rely on experience-based hypotheses. Our study aimed to assess swallowing and speech outcomes following objective volumetric tongue reconstruction with free flaps. 방법:Prospective study in Plastic Surgery and Head-Neck Oncosurgery units. Included patients undergoing free flap reconstruction for Partial Glossectomy (PG), Hemiglossectomy (HG), or Subtotal Glossectomy (SG). Outcome measures included swallowing, assessed using MDADI scores, voice assessment using PRAAT score, and speech assessment using SIS score. Intra-operatively, volumes of resected tongue and flap measured using WATER DISPLACEMENT METHOD. Postoperative flap volume assessed by radiological imaging. Outcome analyses conducted at 1 month post- surgery, immediately post-radiotherapy (RT) and 3 months post-RT. 결과:35 patients (8 male, 27 female) included. Glossectomy defects PG (N=22), HG (N=8),and SG (N=5) reconstructed using RAFF (N=17) or ALT(N=18). Harvested flap volume was 20% more than resected tongue volume. Majority patients received postoperative RT (N=30). Significant improvement in MDADI scores observed over 6-month follow- up period. Speech outcomes, by SIS scores showed significant improvement over time. Mean flap volume loss 41%. PG, HG, and SG groups showed statistically similar MDADI, PRAAT, and SIS scores following reconstruction with either type of free flap. Type of glossectomy defect and corresponding defect volume did not significantly impact MDADI, PRAAT, or SIS outcomes. Patients who underwent PORT had greater flap volume loss (42%). PORT did not adversely affect MDADI, PRAAT, or SIS scores up to the 6-month follow- up. 결론:Free flap reconstruction significantly improves functional and quality-of-life outcomes following glossectomy, regardless of extent of defect. Flap volume loss occurs over time, it does not negatively impact swallowing or speech outcomes if sufficient volumetric replacement is achieved. Our findings provides objective evidence highlighting importance of adequate volume based defect correction during surgery.


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