带血管蒂鼻中隔黏膜瓣在T1、T2期复发性鼻咽癌术后修复中的应用  

Application of vascular pedicled nasoseptal flap in postoperative repair of recurrent nasopharyngeal carcinoma in T1 and T2 stages

作　　者：卫亚楠 邢宇轩 俞晨杰[1] 程诚 WEI Yanan;XING Yuxuan;YU Chenjie;CHENG Cheng(Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Drum Tower Hospital of Nanjing University Medical School,Research Institution of Otorhinolaryngology,Drum Tower Hospital,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科,南京鼓楼医院耳鼻咽喉研究所,南京210008

出　　处：《医学研究与战创伤救治》2024年第11期1186-1189,共4页Journal of Medical Research & Combat Trauma Care

基　　金：南京鼓楼医院临床研究专项(2022-LCYJ-MS-31);南京鼓楼医院新技术发展基金(XJSFZJJ201931)。

摘　　要：目的 探讨带血管蒂鼻中隔黏膜瓣(HBF)在T1、T2期复发性鼻咽癌鼻内镜手术中的应用及疗效。方法 回顾性分析2019年7月至2022年3月于南京鼓楼医院耳鼻咽喉头颈外科进行鼻内镜下鼻咽部肿瘤切除术的10例T1、T2期复发性鼻咽癌患者。其中8例行HBF修复,1例行阔筋膜修复,1例未行修复。所有患者均经鼻内镜下手术,切除肿瘤后运用HBF或阔筋膜瓣修复创面。分析其疗效及并发症。结果 所有患者均经鼻内镜完成手术并实现肿瘤完整切除。8例行HBF修复者黏膜瓣成活,鼻咽部愈合理想,无创面感染坏死,无干痂,无嗅觉减退,发生鼻中隔小穿孔1例。所有患者无瘤生存。8例HBF患者术后NRS、SNOT-22评分较术前下降。结论 HBF可有效修复鼻咽部肿瘤术后创面,保护颅底重要结构并减少了并发症。Objective To investigate the application and efficacy of vascular pedicled nasoseptal flap(HBF)in endoscopic surgery for recurrent nasopharyngeal carcinoma at T1 and T2 stages.Methods A retrospective analysis was performed on 10 pa‐tients with recurrent nasopharyngeal carcinoma in stages T1 and T2 treated at Department of Otolaryngology Head and Neck Surgery in Nanjing Drum Tower Hospital from July 2019 to March 2022.Among them,8 cases underwent HBF repair,1 case underwent fascia la‐ta repair,and 1 case did not undergo repair.All patients underwent nasal endoscopic surgery,and the wound was repaired by HBF or fascia lata flap after tumor resection.The curative effect and complications were analyzed.Results All patients underwent endo‐scopic surgery and complete tumor resection.In 8 patients who underwent HBF repair,the nasoseptal flap survived,the nasopharyngeal healing was ideal,there was no wound infection and necrosis,no dry scab,no anosmia,and 1 case had small nasal septum perforation.All patients survived without tumor.The NRS and SNOT-22 scores of 8 HBF patients decreased after operation.Conclusion The vascular pedicled nasoseptal flap can effectively repair the postoperative wound surface of nasopharyngeal tumors,protect the important structure of the skull base and reduce complications.

关 键 词：复发性鼻咽癌 带血管蒂鼻中隔黏膜瓣 鼻 内镜 

分 类 号：R739.62[医药卫生—肿瘤]