新規PLA吸収性メンブレンを用いた舌側方欠損の再建 - パイロット報告

Tongue reconstruction is a complex surgical procedure that may require intricate microvascular surgery that increases morbidity rate and length of hospital stay. The use of new materials to enable easier procedures is currently a vast focus of research. We report the feasibility of use of a novel Polylactide Membrane (PLM) to reconstruct post-oncologic lateral tongue defects.

Patients included in the trial presented to the outpatient ENT clinic complaining of lesions/tumours of the lateral tongue requiring resection and reconstruction. After resection, the PLM was fixed onto the defect bed and sutured in place using resorbable sutures. The patients were hospitalized for an average of 5 days with assessment of healing (photographs were taken), pain scores and need for analgesia and assessment of tongue function by video recording of movement and reading of a standard German text.

A total of 7 patients were included in this report with no complications noted postoperatively. All cases were fully oralised by day 2 postoperatively and by day 5 speech was classified comprehensible. Patients reported low pain levels postoperatively and no bleeding episodes were noted. in cases where non- sano resection was identified (3 of our cases); a 2nd surgery was performed and clear margins were confirmes before the PLM was placed in the same manner.

The use of PLM may be a promising alternative to tongue and mucosal reconstruction. The resorption of the membrane starts on day 2 postoperatively allowing for the granulation of the underlying defect bed while the PolyLactide residue continues to enhance healing and reduce pain.