中晚期上颌窦癌切除术保留眶内容物的眶底修补  

Reconstruction of orbital floor defect with preserved orbital contents after advanced maxillary sinus cancer resection

作　　者：胡厚洋 张二朋 李冰[1] 程雪晴 张贵玲 时蕾[1] 时光刚[1] Hu Houyang;Zhang Erpeng;Li Bing;Cheng Xueqing;Zhang Guiling;Shi Lei;Shi Guanggang(Department of Otorhinolaryngology Head and Neck Surgery,Shandong First Medical University Affiliated Shandong Provincial Hospital,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属山东省立医院耳鼻咽喉头颈外科,济南250022

出　　处：《中华耳鼻咽喉头颈外科杂志》2020年第1期29-33,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的分析侵犯眼眶的中晚期上颌窦癌保留眶内容物的眶底修补方法及效果。方法回顾性分析2010年1月至2016年10月于山东省立医院耳鼻喉头颈外科行外科治疗的33例侵犯眼眶的T3/T4期上颌窦癌患者的临床资料,其中男20例,女13例,年龄12~80岁。根据患者的临床症状、影像学表现、病变侵袭范围、术前及术中病理进行详细评估,选择合适的手术入路及手术方法。采用上颌骨全切术、上颌骨扩大切除术、上颌骨高位切除术等手术方式,均伴Medpor眶底修补术。术后对患者进行定期随访,采用描述性统计学方法探讨手术疗效。结果33例患者中鳞状细胞癌19例,腺样囊性癌8例,内翻性乳头状瘤恶变5例,上颌窦肌上皮癌1例。眶底修补后患者眶内容物、眼球眼位、视力等功能均保留完好。随访3~8年,随访3年时共6例患者复发,治疗无效死亡,患者生存率81.8%(27/33)。结论肿瘤切除+Medpor眶底修补术可以很好地保留患者眶内容物、眼球眼位、视力等功能,提高患者的生存质量。Objective To analyze the method and effect of reconstruction of the orbital floor defect with preserved orbital contents after advanced maxillary sinus cancer resection.Methods Thirty-three patients of T3/T4 stage maxillary sinus cancer with orbital invasion who were treated in Shandong Provincial Hospital from January 2010 to October 2016 were retrospectively analyzed,including 20 males and 13 females,aged from 12 to 80 years old.Patients were treated with appropriate surgical methods according to their clinical manifestation,imaging finding,invasion range,preoperative and intraoperative pathology.Surgical approaches such as maxillectomy,expanded maxillectomy and superstructure maxillectomy were used for patients with Medpor orbit floor repairment.Patients were followed up regularly after surgery,and the surgical efficacy was discussed by descriptive statistical method.Results Of those 33 cases,19 were squamous cell carcinoma,8 were adenoid cystic carcinoma,5 were inverted papilloma malignant transformation,and 1 was myoepithelial carcinoma in our study.After tumor resection and orbital floor repair,the orbital contents and eyeball function of all patients remained intact.During follow-up time ranged from 3 to 8 years,a total of 6 patients relapsed at 3 years and died of ineffective treatment.The survival rate was 81.8%(27/33).Conclusion Tumor resection and Medpor orbital floor repair in maxillary sinus cancer patients with orbital invasion can preserve the function of the eyeball well,greatly improve the quality of patient′s life.

关 键 词：上颌窦肿瘤 眼眶 MEDPOR 眶底修补术 

分 类 号：R73[医药卫生—肿瘤]