鼻黏膜瓣在鼻咽癌放疗后鼻咽颅底骨质裸露修复中的应用  

Clinical application of nasal mucosa flap in the repair of nasopharyngeal skull base bone exposure after radiotherapy for nasopharyngeal carcinoma

作　　者：李峰 蔡泽虹 许卫华 周慧 麦颖达 刘晓瑜 潘文芳 章诗富 LI Feng;CAI Zehong;XU Weihua;ZHOU Hui;MAI Yingda;LIU Xiaoyu;PAN Wenfang;ZHANG Shifu(Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Guangdong Medical University,Guangzhou,524001,China)

机构地区：[1]广东医科大学附属医院耳鼻咽喉头颈外科,广州524001

出　　处：《临床耳鼻咽喉头颈外科杂志》2021年第10期929-934,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广东省社会发展项目(No:21101k01101)。

摘　　要：目的:观察鼻黏膜瓣在鼻咽癌放疗后鼻咽颅底骨质裸露修复中的效果,为鼻黏膜瓣在放疗后颅底骨质裸露中的修复提供依据。方法:回顾性分析8例行鼻内镜下鼻黏膜瓣修复鼻咽颅底骨质缺损或裸露的患者资料,术后随访黏膜瓣存活情况、骨质缺损或裸露处黏膜上皮化情况,以及患者主要临床症状改善和并发症情况。结果:除1例患者术后出现较严重的黏膜瓣坏死、骨质裸露,余7例患者黏膜瓣存活且鼻咽部黏膜上皮恢复良好。术后大部分患者头痛、鼻臭等临床症状较术前改善。结论:鼻黏膜瓣是一种安全和微创的自体材料,具有较好的生物相容性,在修复放疗后鼻咽颅底骨质缺损或裸露中具有良好的应用前景,值得临床推广。Objective: To observe the effect of nasal mucosa flap in the repair of nasopharyngeal skull base bone exposure after radiotherapy for nasopharyngeal carcinoma, and to provide a basis for the repair with nasal mucosa flap in skull base bone exposure after radiotherapy. Methods: The clinical data of 8 patients who underwent nasal endoscopic surgery were analyzed retrospectively. The survival of mucosal flap, the mucosal epithelialization of bone defect or exposed site, the improvement of main clinical symptoms and complications were followed up after operation. Results: Severe mucosal flap necrosis and bone exposure occurred in 1 case after operation, in the other 7 cases, the mucosal flap survived and the mucosal epithelium of nasopharynx recovered well. After operation, most of the patients’ clinical symptoms such as headache and nasal odor were improved compared with those before operation. Conclusion: Nasal mucosal flap is a safe and minimally invasive autogenous material with good biocompatibility. It has a good application prospect in repairing bone defect or exposure of nasopharyngeal skull base after radiotherapy and is worth popularizing in clinic.

关 键 词：鼻咽肿瘤 鼻黏膜瓣 修复外科手术 

分 类 号：R739.63[医药卫生—肿瘤]