口腔・中咽頭進行癌症例—口蓋再建と構音機能

Advanced Cases of Oral and Mesopharynx Cancer: Reconstruction of the Palate, and the Speech Articulation

I．はじめに

　口腔，咽頭は構音，咀嚼，嚥下に重要な都部位であるため，患者は微細な症状でも自覚すると悪性か否かを心配して来院するはずである。

　しかし頭頸部領域の癌の存在に関する知識が他臓器のそれに比しまだ一般には普及していないため，来院時進行癌となっている症例も多々ある。

　An extended radical operation was performed in 3 patients, two 56-year-old females with adenocarcinoma of the hard palate and a 66-year-old male with squamous cell carcinoma of the upper and lateral wall of the mcsopharynx.

　With a pedicled latissimus dorsi myocutaneous flap, we reconstructed the palate and lateral wall of the meso-and hypopharynx for the first patient; the palate, lateral mesopharyngeal wall and buccal soft tissue for the second patient: and the palate, lateral meso-and hypopharyngeal wall and the base of the tongue for the third patient.

　The result was excellent in 2 patients and moderate in one patient according to the criteria defined by a research group sponcered by Ministry of Public Welfare for the evaluation of post-operative function on speech articulation.

　We consider it also useful for restoring the speech articulation function to use a thin forearm flap or an intestinal graft as reconstruction materials.