扁桃体癌的手术治疗

Surgical treatment of tonsillar cancer

目的 探讨扁桃体癌手术治疗的方法及其疗效。方法 对 2 4例扁桃体癌进行手术治疗。根据病变情况不同 ,采用经口入路、下颌骨切开外旋入路、下颌骨切除入路、经舌骨入路等 4种不同的手术入路切除肿瘤 ,以胸大肌肌皮瓣、胸骨舌骨肌筋膜瓣、舌瓣后置、软腭黏膜瓣修复组织缺损。所有患者术后行放疗。结果 3年生存率为 76.0 % ,5年生存率为 60 .8%。患者咀嚼、吞咽、呼吸、语言功能恢复良好。结论 选择合适的手术入路 ,在彻底切除肿瘤的前提下 ,尽量减少手术创伤 ,最大限度地重建患者的口咽功能 ,并辅以术后放疗 。

ObjectiveTo study the surg ical treatment of tonsillar cancer. Methods Twenty-four patients with tonsillar cancer were treated with surgery and postoperative radiotherapy. The choice of surgical procedure was decided on the condition of the lesion. The tumor was resected through the transoral approach, mandibular swing approach, mandiblar resection approach or hyoid approach. Surg ical defect was repaired by pectoralis major myocutaneous flap, sternohyoid myo fascial flap, tongue flap or soft palate flap. Results The 3- and 5-year surv ival rates were 76.0% and 60.8%. Function of chewing, deglutition, respiration and speech was restored well. Conclusion Method of total resection of the to nsillar carcinoma through the optimum approach is best chosen according to the c ondition of the lesion, while preserving the oropharyngeal function. When combin ed with postoperative radiotherapy, the survival rate and quality of life of pat ients can be improved.