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[鼻咽癌放疗后颞骨弥漫性放射性骨坏死的外科治疗]

[Surgical treatment of diffused osteoradionecrosis of temporal bone in cases with nasopharyngeal carcinoma after radiotherapy].

作者信息

Ou Yong-Kang, Xu Yao-Dong, Zheng Yi-Qing, Wu Shu-Nong, Zhang Shao-Yan, He Xiao-Zheng, Xu Xiu-Juan

机构信息

The Department of Otolaryngology, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510120, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Jan 9;87(2):121-3.

Abstract

OBJECTIVE

To investigate the effective treatment method of osteoradionecrosis (ORN) of temporal bone in the patients with nasopharyngeal carcinoma (NPC) after radiotherapy.

METHODS

Eight NPC patients (8 ears) with ORN of temporal bone accepted surgical treatment, 2 ears undergoing radical mastoidectomy, 2 ears undergoing extensive radical mastoidectomy, 5 ears undergoing radical mastoidectomy and obliteration with transferring local vascularized fascia flaps.

RESULTS

Five of the 8 ears (62.5%) achieved dry ear, including 4 ears undergoing radical mastoidectomy and obliteration with vascularized fascia flaps, and 1 ear undergoing radical mastoidectomy. Two of the 8 ears (25%) still had infection and were not fully epithelized, but without sequestration, including 1 ear undergoing mastoidectomy and obliteration with vascularized fascia flaps, and 1 ear undergoing extensive radical mastoidectomy. One of the 8 ears (12.5%) which had received radical mastoidectomy needed revision surgery because of re-sequestration.

CONCLUSION

The surgical treatment for diffused ORN of temporal bone by radical mastoidectomy and obliteration with local vascularized flaps is effective. The main objective of the surgery is get excellent drainage and prevention of complications.

摘要

目的

探讨鼻咽癌(NPC)放疗后颞骨放射性骨坏死(ORN)的有效治疗方法。

方法

8例NPC合并颞骨ORN患者(8耳)接受手术治疗,其中2耳行乳突根治术,2耳行扩大乳突根治术,5耳行乳突根治术并转移局部带血管筋膜瓣填塞术。

结果

8耳中5耳(62.5%)干耳,其中4耳行乳突根治术并带血管筋膜瓣填塞术,1耳行乳突根治术;8耳中2耳(25%)仍有感染且未完全上皮化,但无死骨形成,其中1耳行乳突根治术并带血管筋膜瓣填塞术,1耳行扩大乳突根治术;8耳中1耳(12.5%)行乳突根治术后因死骨复发需再次手术。

结论

采用乳突根治术并局部带血管瓣填塞术治疗弥漫性颞骨ORN有效,手术主要目的是获得良好引流并预防并发症。

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