改良颞骨切除术治疗中耳恶性肿瘤  

Modified subtotal resection of temporal bone on patients with middle ear carcinoma-Report of 14 cases

作　　者：蒋立新 孙连玉[2] 柴利[3] 陈少茹[4] 宋德辉[4] 梁鸿雁[2] 李晓俞[2] 

机构地区：[1]广州市耳鼻咽喉-头颈外科医院,510620 [2]锦州医学院附属第一医院耳鼻咽喉科 [3]辽宁省葫芦岛市中心医院耳鼻咽喉科 [4]汕头大学第一临床学院耳鼻咽喉科

出　　处：《耳鼻咽喉（头颈外科）》2002年第5期269-271,共3页Chinese Arch Otolaryngology-Head Neck Surg

基　　金：辽宁省科学计划项目暨科三项目资助 (项目批号2 0 0 12 2 5 0 0 1

摘　　要：目的 :评估改良颞骨切除术治疗中耳恶性肿瘤的临床疗效。方法 :按 Fisch氏侧颅底手术大“S”形切口 ,改良“整块”凿除颞骨为“分块状”磨除的方法 ,用显微电钻将乳突、外耳道、鼓部及岩部分块磨除。在手术显微镜下处理颅底、乙状窦、颈内动静脉、咽鼓管鼓口、面神经及迷路病变。转带蒂肌瓣修补术腔。结果 :14例中耳癌 ,4 /14例颈廓清术 ,2 /14例髁状突切除术 ,4 /14例腮腺切除术 ,3/14例面神经移植吻合术 ,术后 2年面神经功能达 ～ 级。 3/14例硬脑膜修补术 ,术后无脑脊液漏。 4 /14例迷路切除术 ,术后眩晕 5～ 9周好转。结论 :改良颞骨切除术安全彻底 ,并发症少 ,尤其对侵犯迷路、颞颌关节及颅底内病变更优于“整块”Objective: To evaluate the clinical results by the surgery of modified subtotal resection of the temporal bone on patients with middle ear carcinoma. Methods: Fourteen patients with middle ear carcinoma were treated by surgery in our department from 1988 to 2000. There were 9 males and 5 females, ranging in age from 41 to 77 years old. The classification of clinical stage, 1 was stage Ⅱ, 2 were stage Ⅲ and 11 were stage Ⅳ. The Fisch approach was modified for this subtotal resection of the temporal bone. Among 14 patients, 4/14 were selective neck dissection, 2/14 were candylectomy,4/14 were parotid gland resection,3/14 were facial nerve anatomosis, 3/14 were repair of dura defect cerebrosoinal fluid leak, 4/14 were hemilabyrinthectomy. Results: The 2\|year and 5\| year survival rate were 85.71% and 66.67% respectively. Conclusion: The procedure of surgery of modified subtotal resection of the temporal bone on patients with ear carcinoma has less complications and should be beneficial good quality life of patients.

关 键 词：改良颞骨切除术 治疗 中耳恶性肿瘤 外科手术 

分 类 号：R739.61[医药卫生—肿瘤] R730.56[医药卫生—临床医学]