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口腔颌面部肿瘤术后言语障碍的评估和康复管理专家共识

Expert consensus on the assessment and rehabilitation management of speech disorders following oral and maxillofacial tumor surgery

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【作者】 李小莹； 孙沫逸； 郭伟； 唐瞻贵； 李龙江； 任国欣； 孙志军； 尚伟； 张杰； 孟箭； 李吉辰； 杨凯； 何悦； 李春洁； 秦力铮； 李波； 吴炜； 梁秦龙； 倪前伟； 李建虎； 杨向明； 周小燕； 杨帆； 李家存； 高涛；

【Author】 LI Xiaoying;SUN Moyi;GUO Wei;TANG Zhangui;LI Longjiang;REN Guoxin;SUN Zhijun;SHANG Wei;ZHANG Jie;MENG Jian;LI Ji chen;YANG Kai;HE Yue;LI Chunjie;QIN Lizheng;LI Bo;WU Wei;LIANG Qinlong;NI Qianwei;LI Jianhu;YANG Xiangming;ZHOUXiaoyan;YANG Fan;LI Jiacun;GAO Tao;Department of Medical Rehabilitation, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology,The Third Affiliated Hospital of Air Force Medical University;Department of Maxillofacial Oncology,State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology,The Third Affiliated Hospital of Air Force Medical University;Department of Oral and Maxil-lofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine;Xiangya Medical School of Stomatology, Central South University;State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology,West China Hospital of Stomatology,Sichuan University;School of Stomatology Wuhan University;Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qingdao University;Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology;Xuzhou Central Hospital;The First Affiliated Hospital of Harbin Medical University;Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University;Department of Maxillofacial Oncology, Beijing Stomatological Hospital Affiliated to Capital Medical University;Affiliated Stomatology Hospital of Guilin Medical Universityy;Department of Maxillofacial Oncology, Shaanxi Provincial Cancer Hospital;Maxillofacial Surgery Department of Xinjiang Military Region General Hospital;Shaanxi Provincial People’s Hospital;Department of Public Health and Preventive Medicine, Yan’an Medical College of Yan’an University;The Third Affiliated Hospital of Air Force Medical University;

【通讯作者】 孙沫逸;

【机构】 口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,空军军医大学第三附属医院医疗康复科； 口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,空军军医大学第三附属医院口腔颌面头颈肿瘤科； 上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科； 中南大学湘雅口腔医院； 口腔疾病防治全国重点实验室,国家口腔医学中心,国家口腔疾病临床医学研究中心,四川大学华西口腔医院头颈肿瘤外科； 武汉大学口腔医学院； 青岛大学附属医院口腔颌面外科； 北京大学口腔医学院口腔颌面外科； 徐州市中心医院； 哈尔滨医科大学附属第一医院； 重庆医科大学附属第一医院口腔颌面外科； 首都医科大学附属北京口腔医院口腔颌面头颈肿瘤科； 桂林医科大学附属口腔医院； 陕西省肿瘤医院头颈肿瘤外科； 新疆军区总医院颌面外科； 陕西省人民医院口腔科； 延安大学医学院公共卫生与预防医学教研室； 空军军医大学第三附属医院；

【摘要】 外科手术的进步使许多口腔颌面部肿瘤患者能够得到有效的治疗，但术后由于发音器官的缺损和组织瓣修复的代偿功能不足可能出现咀嚼、吞咽和言语障碍等问题。尤其是言语障碍，它使患者与他人沟通困难而感到孤立，不但影响患者的生活质量，还可能引发心理问题和社会交往障碍。尽管手术及放化疗引起言语功能障碍导致的生活质量下降等相关问题已得到大家广泛关注，但目前国内外针对口腔颌面部肿瘤术后合并言语障碍的问题尚未形成标准化通用的评估方法和规范的康复治疗管理指南或共识。在前期临床实践的基础上，结合口腔颌面肿瘤术后患者言语障碍的特点及总结颌面肿瘤外科和康复领域专家的临床经验，回顾和总结国内外相关文献，组织相关专家经共同讨论、修改，主要从言语障碍的评估和早期康复治疗管理的实施方案等核心内容方面达成共识，以期改善患者与言语相关的生活质量并提高口腔颌面肿瘤术后言语障碍的评估和康复治疗技术，为临床提供参考。

【Abstract】 The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors. However, post-surgery problems such as chewing, swallowing and speech difficulty may arise due to the defects in speech organs and inadequate compensatory function of tissue flap repair. Speech disorders, in particular, isolate patients by making it difficult for them to communicate with others, not only impact their quality of life but also potentially lead to psychological problems and social interaction disorders. Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemotherapy have been widely recognized, there is currently no standardized and universally applicable assessment method and standardized rehabilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad. Based on previous clinical practice, combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery, the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature, relevant experts organized discussions and modifications, reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management, providing a reference for clinical practice, in order to improve patients’ speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.

【关键词】 口腔颌面部肿瘤； 言语障碍； 评估和康复管理；
【Key words】 Oral and maxillofacial tumors； Speech disorders； Assessment and rehabilitation management；
【基金】 空军军医大学第三附属医院新技术新业务(编号：LX2021-427)
  • 【文献出处】 实用口腔医学杂志 ,Journal of Practical Stomatology , 编辑部邮箱 ,2025年01期
  • 【分类号】R739.8
  • 【下载频次】134
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