下颌骨外旋径路切除晚期口咽癌的临床研究——附6例报告

Clinical study on mandibular swing approach for resection of advanced-stagy oropharyngeal carcinoma (a report of 6 cases)

目的探讨晚期口咽癌的手术入路和口咽缺损的一期修复。方法采用下颌骨外旋径路切除晚期口咽癌6例,其中口咽侧壁癌5例,舌根癌1例;口咽缺损均采用胸大肌肌皮瓣修复。结果全部病例随访2～7年,4例存活3～7年以上,2例分别于术后1,3年死于局部复发。1例咽瘘,3例短期食物返流入鼻腔。全部病例半年内吞咽、言语功能基本恢复。结论下颌骨外旋径路切除晚期口咽癌,具有视野开阔、直视下完整大块切除肿瘤、且便于修复缺损;胸大肌肌皮瓣修复口咽侧壁、舌根及软腭缺损效果良好。

Objective To invesigate the operative approach and reconstruction for the patient with advanced-stage oropharyngeal carcinoma. Methods 6 cases with advanced-stage oropharyngeal carcinoma were operated on through mandibular swing approach and with immediate reconstruction. Pectoralis major myocutaneous flaps were applied in 6 cases. [WTHZ]Results Following up 1 to 7 years. 4 cases survived for more than 3 years. 2 cases died in 1 to 3 years. 1 case had fistula. 3 cases suffered from temporary regurgitation of food to the nasal chamber. all cases regained the function of swallow and speach in postoperative 6 months. Conclusion [WTBZ]This mandibular swing approach provides good exposure of pharynx. the advanced-stage oropharyngeal carcinoma could be resected under the direct visual field, facilitating reconstruction,and safe with minimal morbidity. The pectoralis major myocutaneous flap had many advantages to the reconstruction of oropharyngeal carcinoma.