面中部掀翻术在头颈肿瘤外科中的应用

Clinical application of midfacial deglove approach in the surgical treatment of tumors of head and ncek

目的探讨面中部掀翻术在头颈肿瘤手术中的应用及疗效。方法回顾性分析38例面中部掀翻手术的临床资料,其中鼻腔鼻窦良性病变14例,鼻腔鼻窦恶性肿瘤24例,TNM分期(UICC 2002):T1N0M05例,T2N0M08例,T3N0M07例,T3N1M01例,T4N0M03例。根据病情分别采用面中部掀翻及其改良术式切除肿瘤。结果 37例完整切除肿瘤,手术切除率97.4%(37/38),无面形改变、鼻孔狭窄等术后并发症。36例患者术后呼吸、吞咽、发声功能均正常。24例恶性肿瘤随访7个月至6年,T1+2期的3、5年生存率分别为85.7%、80%,T3+4期的3、5年生存率为62.5%、33.3%。结论面中部掀翻手术对于鼻腔鼻窦肿瘤和累及前颅窝底肿瘤均取得了良好的疗效,具有较好的临床应用价值。

Objective To investigate the application and curative effect of midfacial deglove in the surgical treatment of tumors of head and ncek.Methods Clinical data of 38 patients receiving surgical treatment of tumors of head and neck via midfacial deglove approach was analyzed respectively.Of them,the pathological diagnosis was benign in 14 cases and malignant in 24.According to UICC 2002 criteria,there were 5 patients in T1N0M0,8 in T2N0M0,7 in T3N0M0,1 in T3N1M0 and 3 in T4N0M0.The midfacial deglove approach or modefied midfacial deglove approach was adopted to remove the tumor based on the state of patient＇s lesion.Results The lesions were excised completely in 37 patients with a total removal rate of 97.4%（37/38）.There were no postoperative complications such as stenosis of the nasal aperture or facial deformity.The functions of respiration,deglutition,phonation returned to normal in 36 patients.The 24 patients with manignant lesions had been followed up for 7 months to 6 years postoperatively.The 3-year and 5-year survival rates of the patients at T1,T2 stages were 85.7% and 80% respectively,and those of the patients at T3,T4 stages were 62.5% and 33.3% respectively.Conclusion With good curative effect,the midfacial deglove approach is an alternative for the surgical treatment of tumors of nasal-paranasal cavities and those invloving anterior cranial fossa.