肩胛舌骨肌上颈清扫术在临床N0口腔癌治疗中的应用  

Application of supraomohyoid neck dissection in oral squamous cell carcinoma with clinically N0 neck

作　　者：郭传瑸[1] 张晔[1] 何冬梅[1] 张雷[1] 俞光岩[1] 毛驰[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,100081

出　　处：《中华耳鼻咽喉头颈外科杂志》2005年第2期87-90,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨肩胛舌骨肌上颈清扫术在口腔癌治疗中的应用价值。方法 对27例临床N0(T1～3)口腔鳞状细胞癌患者行肩胛舌骨肌上颈清扫，清扫范围为第Ⅰ、Ⅱ、Ⅲ区淋巴结。记录颈清扫手术时间、术后淋巴结病理检查结果、术后肩功能及随访结果。结果 手术时间平均(x±s)为(1．6±0．2)h。术后病理检查证实5例出现颈淋巴转移(19％)，转移发生于第Ⅰ区2例(7％)、第Ⅱ区4例(15％)，其中1例同时存在第Ⅰ、Ⅱ区转移。肩功能在术后3个月内基本恢复。术后随访2～4年，随访率100％，未见原发灶复发及颈淋巴转移。结论 肩胛舌骨肌上颈清扫术是临床颈部N0口腔癌的合适术式，它既能达到治疗目的，又能最大程度地保留肩颈部外形与功能。Objectives The value of supraomohyoid neck dissection used in treating oral squamous cell carcinoma was discussed. Methods Twenty-seven cN0 patients with oral squamous cell carcinoma were entered into the study. Supraomohyoid neck dissection was performed to remove the lymphatic tissue of level Ⅰ,Ⅱ, and Ⅲ. The operation duration and shoulder function were recorded. Results The average operation duration was (1.6±0.2)h. Nineteen percent (5/27) of the cN0 neck were proved positive pathologically which included two cases in level Ⅰ and four in level Ⅱ(one case had both level Ⅰand Ⅱ metastases). Shoulder function recovered in three months after operation. All patients were followed up from two years to four years and none of them had local or neck recurrence. Conclusions Supraomohyoid neck dissection is a right choice for cN0 patiens with oral squamous cell carcinoma with its advantages in both curing neck lymphatic metastases and preserving neck and shoulder contours and functions.

关 键 词：肩胛舌骨肌上颈清扫术 临床NO口腔癌 肩功能 适应证 

分 类 号：R739.8[医药卫生—肿瘤]