保留喉舌功能的口咽舌会厌区癌切除术

Preservation of laryngeal and glossal function in surgical treatment of oropharyngeal glossal epiglottic carcinoma

目的 研究保留喉舌功能的口咽舌会厌区癌切除术的手术方法及疗效。方法 对1990～ 2 0 0 0年经治的 2 1例口咽舌会厌区癌进行回顾性临床研究 ,其中男 17例 ,女 4例 ;按 1992年UICC临床分期 ,T2N0 4例 ,T2N15例 ,T3N112例。 2 1例均行部分舌根及喉水平部分切除术。 17例行分区性颈清扫术。术后全部接受 5 0～ 6 0Gy放射治疗。结果 2 0例拔除气管套管 ,完全保留喉舌功能 (95 2 % ) ,1例不能拔管保留了言语功能和吞咽保护功能 (4 8% )。 3年生存率 73 3% (11/15 ) ,5年生存率 5 7 1% (8/14)。

Objective To study the feasibility, surgical techniques and results of surgical treatment of oropharyngeal glossal epiglottic carcinoma with laryngeal and glossal functions preserved. Methods A retrospective review of 21 (17males, 4 females, age range 44 to 72 years) cases with carcinoma extending from the oropharynx, glossa to the epiglottis treated during 1990 to 2000 was conducted. The clinical stage was T2N0 in 4,T2N1 in 5 and T3N1 in 12 according to 1992 UICC. All the cases were undergone partial resection of the glossal base-epiglottis and suproglottic horizontal partial laryngectomy. Seventeen cases received selective neck dissections and all the patients received postoperative radiotherapy (50-60 Gy). Results The 3-year and 5-year survival rates in this series were 73.3% and 57.1%, respectively. Decannulation and complete preservation of laryngeal and glossal functions were achieved in 20 cases (95.7%), while partial preservation (speaking and deglutition) in one case (4.2%). Conclusion Preservation of the laryngeal and glossal functions in surgical treatment of oropharyngeal glossal epiglottic carcinoma is feasible. Subhyoid approach was proved to be the best way for tumor resection in such an extent.