鼻唇沟微笑切口入路在后颊癌根治术中的应用

Application of the nasolabial fold “smile” incision approach in posterior buccal cancer ablation

目的探讨应用鼻唇沟微笑切口入路进行后颊癌根治手术的可行性并评价其临床效果。方法选取2016年8月—2017年3月间行手术治疗的23例后颊癌患者,完成颈部淋巴结清扫术后,在口角外1 cm处的鼻唇沟内设计切口线,即微笑切口。切口呈弧形,向上至鼻翼外下缘,向下与颈淋巴清扫术切口连续。结果23例患者的原发灶术中显露满意,切缘肿瘤细胞均为阴性。术后随访12~22个月,平均16.5个月,所有患者恢复良好,未见肿瘤复发及远处转移。开口度基本恢复正常,面部切口仅在鼻唇沟处遗留隐蔽的类似“微笑”样的瘢痕。结论经鼻唇沟微笑切口入路切除后颊癌,术野显露满意,手术操作便利,在不影响肿瘤根治的前提下避免了对患者口裂完整性的破坏,有助于患者开口度的恢复,切口瘢痕隐蔽,值得临床推广应用。

Objective This study investigated the feasibility and clinical result of radical resection of posterior buccal carcinoma by using the facial nasolabial fold“smile”incision approach.Methods From August 2016 to March 2017,23 patients with posterior buccal carcinoma were included in this study and underwent radical surgery.Upon finishing the cervical lymph node dissection,an arc-shaped incision was made at 1 cm lateral to the ipsilateral angulus oris,extending along the nasolabial fold upward to the inferolateral margin of the nasal alar while downward in direct continuity with the neck dissection incision.Results Satisfactory exposure and easy resection of the primary tumor with negative surgical margin were achieved in all 23 patients.After 12-22 months of follow-up(16.5 months on average),all patients recovered favorably,and no local recurrence or distant metastasis was observed.Mouth opening was restored to normal in all cases.The scars were hidden in the nasolabial fold,thus named“smile”incision.Conclusion For posterior buccal cancer patients,the facial“smile”incision approach can satisfy the need of surgical exposure,facilitate operative performance,and preserve the annular integrity of the lips without affecting the radical tumor ablation,thereby maintaining a favorable mouth opening.With these advantages,the“smile”incision approach is considered worthy of being popularized in clinical application.