[摘要] 目的：舌癌根治术同期行舌缺损游离皮瓣修复重建，评价术后其语言、咀嚼、活动、吞咽等功能恢复效果，以期为舌癌根治切除舌缺损修复重建提供理论依据。方法：选择我院颌面头颈外科2010—2018年间共80例舌癌根治术同期行舌缺损游离皮瓣修复重建患者，按舌缺损范围分为A组，半舌缺损；B组，舌根缺损或部分舌根缺损；C组，半舌缺损及手术涉及同侧口底、颌骨。有2.5年以上跟踪随访时间。经语言清晰度、咀嚼效率、舌运动范围、吞咽造影剂透视显示吞咽模式等测定，对舌修复重建后的舌形态及运动、语言、咀嚼、吞咽功能进行效果评价。结果：80例舌癌扩大切除舌缺损同期前臂皮瓣修复重建后，患者语音尚清晰，并且修复的部位及范围不同与患者术后语音清晰度有明显差异，且差异具有统计学意义（P＜0.05）；C组与A、B两组相比舌侧伸和抬举运动受限较明显，但咀嚼效率及吞咽功能差异不具有统计学意义（P＞0.05）。结论：舌癌扩大切除舌缺损前臂皮瓣修复重建后其形态与功能可获得较为良好的恢复，但舌根癌修复后其伸展功能较差。

[Abstract] Objective: To evaluate the effect of tongue defect free flap reconstruction after radical resection of tongue cancer, and to provide theoretical basis for tongue defect reconstruction after radical resection of tongue cancer. Methods: from 2010 to 2018, 80 patients with tongue cancer underwent radical operation and tongue defect free flap reconstruction in our hospital were divided into group A, half tongue defect; group B, tongue root defect or partial tongue root defect; group C, half tongue defect and operation involving ipsilateral floor of mouth and jaw. The follow-up time was more than 2.5 years. The tongue shape, movement, language, chewing and swallowing function after tongue reconstruction were evaluated by the measurement of speech clarity, chewing efficiency, range of tongue movement and swallowing pattern displayed by swallowing contrast agent fluoroscopy. Results: 80 cases of tongue cancer extended resection of tongue defect at the same time forearm flap repair and reconstruction, the voice of patients is still clear, and the scope of tongue defect is different, voice clarity has significant difference (P < 0.05); group C tongue body lifting and lateral movement range is more limited than the other two groups, but masticatory efficiency and swallowing function has no significant difference (P > 0.05). Conclusion: after extended resection of tongue cancer, the function of forearm flap can be well recovered, but the extension function of tongue base cancer is poor.