舌根癌的手术治疗

The surgical treatment of cancer in the base of tongue

目的 :探讨舌根癌的手术治疗方法。方法 :舌根癌患者 2 1例 ,经舌骨咽切开进路 11例 ,下颌骨部分切除进路 7例 ,下唇、下颌骨、舌正中切开进路 3例。结果 :3例下唇、下颌骨、舌正中切开者出现语言功能障碍 ,吞咽困难 ;余 18例口腔功能均正常。随访 2～ 5年 ,失访 2例 ,2年生存 18例 ,3年生存 13例 ,5年生存 5例。结论 :经舌骨咽切开进路对吞咽功能及语言功能的影响较小 ,是一种值得推广的术式。

Objective:To seek for a better approach for the resection of carcinoma of the base of tongue.Method:From 1991 to 2000,all 21 cases of tongue base carcinoma had been removed by transhyoid pharyngotomy(11 cases), mandibulectomy(7 cases) and step liked mandibulotomy (3 cases).Result:Three patients with step liked mandibulotomy had speech disorder and dysphagy.The rest had satisfactory speech and swallowing functions. During followed up of 2～5 years,2 cases lost follow up,18 cases were alive at 2 years, 13 cases were alive at 3 years, 5 cases 5 years. Conclusion:Transhyoid pharyngotomy provides good exposure to resect those tumors that involve the base of tongue,epiglottis,hypopharynx and larynx.