舌骨上咽侧进路切除舌根部肿瘤对舌体功能保存的价值  

Suprahyoid parapharyngeal approach for resection of tumors in the tongue base and its functional significance

作　　者：李军[1] 孙坚[1] 张志愿[1] 

机构地区：[1]上海第二医科大学附属第九人民医院,200011

出　　处：《现代口腔医学杂志》2003年第6期512-514,共3页Journal of Modern Stomatology

摘　　要：目的　探讨舌骨上咽侧进路切除舌根部肿瘤的可行性以及保存舌体功能的意义 ,避免传统进路法创伤大、损伤正常结构多和留有唇颌部疤痕等缺陷。方法　本文收集舌根部良恶性肿瘤 12例 ,其中良性肿瘤 2例 ,恶性肿瘤 10例 ,男 8例 ,女 4例 ,年龄 2 3～ 6 2岁 ,全部病例均行舌骨上咽侧进路切除舌根部肿瘤。除良性肿瘤外 ,恶性肿瘤者均行同期修复 ,其中前臂皮瓣 6例 ,胸大肌肌皮瓣修复 4例。结果　经 3～ 2 4个月随访 ,术后皮瓣与肌皮瓣均成活 ,术后 6个月患者经检查舌体外形满意 ,吞咽、语音功能基本恢复 ,未发生口咽瘘。除 1例恶性肿瘤于术后 16个月死于全身转移外 ,其余均健在。结论　该术式主要优点在于在保存舌体和唇颌部正常的解剖外形的同时 ,最大限度地恢复吞咽及语音功能 。Objective To avoid the shortcomings of traditional approaches,this article was designed to evaluate suprahyoid parapharyngeal approach for resection of tumors in the tongue base.Methods Twelve patients with tumors in tongue base were admitted (10 malignant,2 benign;8 male, 4 female).The patients aged from 23 to 63 years.Tumors were excised through the above-mentioned approach and simultaneously reconstructed with free flaps(free forearm flap in 6 patients,free pectoralis major myocutaneous flap in 4 patients with malignance.Results Three to twenty-four month's follow-up showed that:①the survival rate of the free flaps was 100%;②the figuration of tongue,the functions of speech and swallow were basically recovered;③no pharyneal fistula was found.Conclusion Clinical experience proved that the approach was safe.The main advantages were 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 切除术 舌根部肿瘤 舌体功能 手术治疗 

分 类 号：R739.86[医药卫生—肿瘤] R730.56[医药卫生—临床医学]