口腔癌・中咽頭癌手術後の構音障害

抄録

In 94 patients with carcinoma of the tongue, oral floor and oropharynx, articulationfunction was evaluated with 25 and 100 Japanese monosyllables after operation. Simpleresection with CO₂ laser mess was performed in 68 patients. The range of resection waslimited to half of the tongue for oral cavity carcinoma and a little beyond the lateral wallfor oropharyngeal carcinoma. More than 80% of the monosyllables were understandableafter this operation, indicating that the articulation was well conserved by laser surgery. In18 patients with oral cavity carcinoma, more than half of the tongue was removed. Understandablemonosyllables ranged from zero to 82%, depending on the size of the resection.Reconstruction with a myocutaneous flap had little effect on articulation. Nine patientswith oropharyngeal carcinoma had wide resection to the adjacent site from the primary sitein the oropharynx or other region. From 5 to 83% of monosyllables were understandable.After wide resection of the base of tongue, articulation was poor. Articulation was moderatelydisturbed by combined resection of hard palate, and restored well by reconstruction witha rectus abdominalis myocutaneous flap.