颈-颌-扁桃体联合径路手术治疗晚期扁桃体癌

Operation on advanced stage tonsillar cancer by combined neck-mandible-oral cavity approach and immediated reconstruction

目的:探讨晚期扁桃体高分化鳞癌有效的手术治疗方式及术后缺损的Ⅰ期修复。方法:对2例晚期扁桃体高分化鳞癌患者,行功能性颈清扫术,经颈颌扁桃体联合进路切除肿瘤,并采用胸大肌肌皮瓣Ⅰ期修复。结果:术后分别随访2和3年,均健在,无肿瘤复发,功能恢复满意。结论:对晚期扁桃体高分化鳞癌手术治疗宜取颈颌扁桃体联合径路肿瘤切除术式,配合功能性颈淋巴结清扫术;胸大肌肌皮瓣具有取材方便,肌皮瓣成活率高,适合咽部缺损修复。

Abstract Objective; To investigate the operative approach and reconstruction for the patients with advanced stage tonsillar cancer, Methods： 2cases with advanced stage tonsillar cancer were operated by combined neck-mandible-oral cavity approach（CNMOCA） and with immediate reconstruction. Pectoral major museulocutaneous（PMM） flaps were repaired in stage I for 2 cases. Results：2 cases who were operated by CNMOCA with reconstraction were followed up from 2 years to 3 years. They had not recurrence of tumor and complication, all of function recovery were satisfied. Conclusions：CNMOCA is able to provide a good exposure method to remove the extensive tumors completely for the patients with advanced stage tonsillar cancer. PM was usually survived and easily obtained,it was ,suitable for repairing the pharyngeal defect.