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[恶性唇部肿瘤的外科治疗。个人经验]

[Surgical treatment of malignant lip tumors. Personal experience].

作者信息

Moretti A, Zingariello P, Chiri Z M, D'Agostino L, Croce A

机构信息

Sezione di Otorinolaringoiatria, Dipartimento di Scienze Chirurgiche Sperimentali e Cliniche, Università degli Studi G. d'Annunzio di Chieti, Pescara.

出版信息

G Chir. 2003 Oct;24(10):341-6.

Abstract

The malignant tumours of the lip account for nearly 1-2% of the cervicofacial neoplasms. These lesions are frequently spinous cell carcinomas and basal cell carcinomas (25% of all oral cancers). The spinous cell carcinoma is mainly located in the lower lip, the basal cell carcinoma is more common in the upper lip. The incidence of lip cancer in males is much high than in females. The etiopathogenesis of these lesions is connected with exposure to sun, smoking, genetics predisposition (mutation of the p53 suppressor factor) and with the evolution of precancerous lesions (radiodermatitis, chronic cheilitis, xeroderma pigmentosum). Some Authors emphasized the viral etiopathogenesis: HPV16, HPV24, HSV1, HSV2. The treatment of lip carcinoma is surgical: excision and reconstruction. The numerous reconstructive techniques are mostly the cutaneous local sliding flaps and the rotation flaps. The lip reconstruction require a remarkable diligence for preserve, as much possible, the shape and functions of lip. The Authors report their experience about the surgical treatment of 19 patients with lip carcinoma (16 spinous cell carcinomas, 3 basal cell carcinomas) and describe the main surgical reconstructive techniques to preserve the feeding, phonation and mimic expression.

摘要

唇部恶性肿瘤约占面颈部肿瘤的1%-2%。这些病变常见为棘细胞癌和基底细胞癌(占所有口腔癌的25%)。棘细胞癌主要位于下唇,基底细胞癌在上唇更为常见。唇癌的发病率男性远高于女性。这些病变的病因与阳光照射、吸烟、遗传易感性(p53抑制因子突变)以及癌前病变(放射性皮炎、慢性唇炎、着色性干皮病)的演变有关。一些作者强调病毒病因:HPV16、HPV24、HSV1、HSV2。唇癌的治疗方法是手术:切除和重建。众多的重建技术大多是皮肤局部滑行皮瓣和旋转皮瓣。唇部重建需要格外用心,尽可能保留唇部的形状和功能。作者报告了他们对19例唇癌患者(16例棘细胞癌,3例基底细胞癌)的手术治疗经验,并描述了主要的手术重建技术,以保留进食、发声和表情功能。

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