Wang Yue-jian, Chen Wei-xiong, Zhu Zhao-feng, Li Feng-ping
Department of Otorhinolaryngology, The First Peoples Hospital of Foshan, Foshan 528000, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2005 Nov;40(11):810-3.
To evaluate salvage surgical approaches and efficacy for post-radiation local recurrent nasopharyngeal carcinoma (NPC).
Thirteen patients with post-radiation local recurrent NPC underwent salvage surgical treatment by routes as transpalatal approach, nasal medial swing approach, maxillary swing approach and infratemporal fossa approach. All cases were followed up for 2 to 5 years. Analysis was done on the indications and efficacy of these 4 different approaching routes.
No immediate operative complications occurred for all these 13 cases. Four patients with T1 and T2a operated via transpalatal approach and nasal medial swing approach survived more than 3 years. Five patients with T2b and T3 operated via maxillary swing approach. Among them, two patients died at second and 24th month after operation, one survived with tumor and died at 13rd month after operation, two were alive free of tumor for 2 and 4 years after operation. Four patients with T4 operated via infratemporal fossa approach. Among them, three died in 1 year, one was alive free of tumor for 2 years.
Surgical approaches were decided by a comprehensive consideration of recurrent tumor site and invasive range to achieve the best operative site exposure with minimal traumatic damage.
评估挽救性手术方法及对放射治疗后局部复发性鼻咽癌（NPC）的疗效。
13例放射治疗后局部复发性NPC患者采用经腭入路、鼻内侧摆动入路、上颌骨摆动入路和颞下窝入路等途径进行挽救性手术治疗。所有病例均随访2至5年。对这4种不同入路途径的适应证及疗效进行分析。
这13例患者均未发生即刻手术并发症。4例T1和T2a期患者经腭入路和鼻内侧摆动入路手术，存活超过3年。5例T2b和T3期患者经上颌骨摆动入路手术。其中，2例分别于术后第2个月和第24个月死亡，1例带瘤存活，术后第13个月死亡，2例术后无瘤存活2年和4年。4例T4期患者经颞下窝入路手术。其中，3例在1年内死亡，1例无瘤存活2年。
手术入路需综合考虑复发性肿瘤的部位和侵犯范围，以实现最佳的手术视野暴露并使创伤损害最小。
