上颌骨摆动术后腭瘘的消除。
Elimination of palatal fistula after the maxillary swing procedure.
作者信息
Ng Raymond W M, Wei William I
机构信息
Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China.
出版信息
Head Neck. 2005 Jul;27(7):608-12. doi: 10.1002/hed.20220.
BACKGROUND
The maxillary swing procedure has been used as an anterolateral approach to expose the nasopharynx, the central skull base, and its vicinity. The reported incidence of postoperative palatal fistula has ranged from 20% to 25%. The oronasal incompetence especially associated with a large fistula has adversely affected normal speech, eating, and swallowing functions. We describe a modified palatal incision to reduce the incidence of palatal fistula associated with the maxillary swing procedure.
METHODS
Fifteen consecutive patients who underwent maxillary swing procedures for salvage resection of recurrent nasopharyngeal carcinoma after radiotherapy had the modified palatal incision. The flap was raised as described, and the outcome was analyzed.
RESULTS
Fourteen patients' palatal wound healed uneventfully. One patient experienced partial flap necrosis, which healed with conservative treatment. All 15 patients tolerated oral feeding 1 week after the surgery. No palatal fistulas occurred.
CONCLUSION
The modified palatal incision as described has effectively prevented palatal fistula formation after the maxillary swing procedure.
背景
上颌骨摆动手术已被用作一种前外侧入路，以暴露鼻咽部、中颅底及其附近区域。报道的术后腭瘘发生率在20%至25%之间。口鼻腔功能不全，尤其是与大瘘管相关的情况，对正常的言语、进食和吞咽功能产生了不利影响。我们描述了一种改良的腭切口，以降低与上颌骨摆动手术相关的腭瘘发生率。
方法
连续15例接受上颌骨摆动手术以挽救性切除放疗后复发性鼻咽癌的患者采用了改良的腭切口。按所述方法掀起皮瓣，并对结果进行分析。
结果
14例患者的腭部伤口愈合顺利。1例患者出现部分皮瓣坏死，经保守治疗后愈合。所有15例患者术后1周均能耐受经口进食。未发生腭瘘。
结论
所述改良腭切口有效预防了上颌骨摆动手术后腭瘘的形成。
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