舌骨上咽侧进路切除舌根部肿瘤的临床应用  

Suprahyoid Parapharyngeal Approach to Base of Tongue Tumors and Its Functional Significance

作　　者：黄志翔[1] 胡永杰[2] 

机构地区：[1]焦作市第二人民医院口腔颌面外科,河南焦作454100 [2]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科,上海市口腔医学研究所,上海市口腔医学重点实验室,上海200011

出　　处：《口腔颌面外科杂志》2008年第5期348-351,共4页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨舌骨上咽侧进路切除舌根部肿瘤的临床可行性以及保存舌体功能的意义。方法:收集2003-08—2007-02期间舌根部肿瘤患者12例,男性7例,女性5例;年龄20～78岁,平均48.6岁;9例为良性肿瘤,1例为异位甲状腺,2例为恶性肿瘤。全部病例均行舌骨上咽侧进路切除舌根部肿瘤。2例术中冰冻切片提示恶性肿瘤患者同期行颈淋巴清扫术,其中1例行前臂皮瓣同期修复,1例胸大肌肌皮瓣修复。结果:10例良性肿瘤患者术后随访检查舌体外形满意,吞咽、语音功能恢复正常,未发生口咽瘘等并发症。2例恶性肿瘤患者术后皮瓣与肌皮瓣均成活,外形与功能恢复良好,除1例恶性肿瘤患者于术后26个月死于癌细胞全身转移外,其余病例随访6个月～4年未见复发。结论:本术式旨在根治舌根部肿瘤的同时,保存舌体和唇颌部正常的解剖外形,并最大限度地恢复吞咽及语音功能,符合功能性外科的手术原则和要求,在临床上具有一定的应用价值。Objective： This article was designed to evaluate suprah.void parapharyngeal approach for resection of tumors in the tongue base. Methods： 12 patients with tongue base tumors were admitted （7 mate, 5 female） from 2003 to 2007. The patients aged from 20 to 78 years, an average of 48.6 years. Patients included 9 cases of benign tumors, 1 malposition thyroid gland and 2 malignant tumors. Tumors were excised through the aformentioned approach, 2 cases of malignant tumor were combined with neck dissection and simultaneously reconstrncted with free flaps （free forearm flap in 1 patients, free peetoralis major myoeutaneous flap in another patient）. Results： 10 patients with benign tumors in root of tongue got good outcome of tongue contour, swallow and speech without pharyngeal fistula. The survival rate of flaps was 100% in 2 patients with malignant tumor. No recurrence in all patients were found after 6-48 months follow up, except 1 patient dead at 26 months because of metastasis. Conclusion： Clinical results proved that the approach was based on the maintenance of figuration of tongue base and natural anatomic structures of lip and mandible, and the functions of speech and swallow, which was in accord with surgical principles of functional surgery.

关 键 词：舌骨上咽侧进路 舌根部肿瘤 手术 

分 类 号：R739.86[医药卫生—肿瘤]