口腔癌広範切除症例に対する嚥下機能再建の意義

抄録

In recent years, marked advances have been made in reconstruction after oral oncologic surgery, and various types of reconstructive flaps have been developed. Since maintenance of the eating and swallowing functions after surgery is most important in the oromandibular region, a standard flap should be selected with due consideration to postoperative function. Reconstruction with a vascularized free rectus abdominis musculocutaneous flap (RAM) as the standard flap with swallowing training and swallowing improving surgeries, with consideration of the characteristics of each deglutition phase, was carried out for defects in patients with tongue and/or oral floor cancer requiring extensive oromandibular resection, as well as in those with oropharyngeal cancer treated by resection of the soft palate and the lateral oropharyngeal wall.
Here, we describe our swallowing improving treatment, the reconstruction with a RAM, swallowing improvement surgery and the pre- and post-operative swallowing training for maintaining the swallowing and eating functions after extensive oral oncologic surgery. This series of treatments is worth considering before total laryngectomy.