Orsel S, Bessède J P, Sauvage J P, Huth J, Bories F, Enaux M
C.H.U. Dupuytren, Service O.R.L., Limoges, France.
Rev Laryngol Otol Rhinol (Bord). 1992;113(3):223-6.
Tumors of the amygdaline region were up until now most often treated by transmandibular buccopharyngectomy (TMBP) with a systematic sacrifice of the mandibular angle. This exercise justified by wide carcinological imperatives, a larger surgical facility and simple immediate postoperative follow-up, in fact systematically shows a substantial esthetic and functional prejudice. This principle was reinforced by the occurrence of osteitis during the first attempts of osseous reconstruction using steel wires opposite the mandibular angle (Dargent, Charachon, 1963). In 1989, Gehanno and Beauvillain published a mandibular conservation technique by vertical paramedian osteotomy, right in front of the mental nerve, shifted from the future field of radiation, with osteosynthesis by titanium plates. This technique appeals to us because it is easy to use, reliable and carcinologically safe. We have currently adopted it with satisfaction for 8 of our patients over an 18-month period, without any case of osteitis and with both good esthetic and functional results.
直到现在，杏仁核区域的肿瘤最常通过经下颌颊咽切除术（TMBP）进行治疗，该手术会系统性地切除下颌角。这种手术方式基于广泛的肿瘤学需求、更大的手术操作空间以及术后简单的即时随访而被合理化，但实际上系统性地显示出了严重的美学和功能损害。在下颌角处使用钢丝进行首次骨重建尝试期间发生的骨炎事件（达让、沙拉雄，1963年）强化了这一原则。1989年，热阿诺和博维兰发表了一种下颌骨保留技术，即通过在颏神经前方垂直于中线进行截骨术，将截骨部位从未来的放疗区域移开，并使用钛板进行骨固定。这项技术吸引我们是因为它易于操作、可靠且在肿瘤学上安全。在过去18个月里，我们目前已满意地将其应用于8例患者，未出现任何骨炎病例，并且取得了良好的美学和功能效果。
