淋巴管瘤或淋巴血管瘤性巨舌症的外科手术治疗

目的 总结淋巴管瘤或淋巴血管瘤性巨舌症的外科治疗经验。方法 分析7例淋巴管瘤或淋巴血管瘤性巨舌症的手术病例,舌背及舌前部有病变者采用术式1;舌背中央、舌前部、舌腹及舌系带均有病变者采用术式2治疗。结果 术式1治疗5例,术式2治疗2例。全部病例术后语言功能正常,4例术后随访10年肿瘤无复发。取得长期效果。结论 两种术式治疗淋巴管瘤或淋巴血管瘤性巨舌症,远期效果好。

Objective This article describes surgical treatment of 7 cases with lymphangiomatous and lymphangio-hemangiomatous macroglossia. Methods Seven cases with lymphangiomatous and lymphangiohemangiomatous macroglossia will be treated by surgical procedure. Five cases with lymphangioma and lymphangiohemangioma on the lingual dorsum and the anterior part of the tongue are treated by the first operative technique, another two cases with lymphangioma and lymphangiohemangioma on the lingual dorsum of anterior two- thirds of the tongue and the inferio- anterior surface of the tongue are treated by the second operative technique. Operative technique are that for retraction, two deep sutures were placed in lateral borders of the tongue. A figure - of - eight ligature is placed around the base of the tongue as a temporary method to control bleeding during surgery. Three V - shaped incisions of the first operative technique are outlined on the lingual dorsal, lingual lateral, and lingual ventral surfaces of the tongue with methylene blue. Three V-shaped incisions of the second operative technique are outlined on the lingual dorsal, lingual lateral, and lingual ventral surfaces of the tongue with methylene blue. The angle of the V on the tongue dorsum was about 1cm in front of the circumvallate papillae and the inverted V was enclosed within the entire tumor. After completion of the incisions and removal of the lesion the remaining parts of the tongue were approximated in three layers. The reconstruction provided a new tip of the tongue that consisted of normal tissue, and the tongue assumed a relatively normal size and shape. Results Five cases of them were treated by the first operative technique, another two cases were treated by the second operative technique. Four cases of them have been followed - up over ten years after surgery, no anyone case has been recurred. All patients have gained an improved facial apperance and good tongue function. Conclusion These operative techniques are specially effective for cases with the lymphangiomatous and lymphangiohemangiomatous macroglossia.