Moncrieff Marc D, Hamilton Stuart A, Lamberty George H, Malata Charles M, Hardy David G, Macfarlane Robert, Moffat David A
Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital NHS Foundation Trust, Cambridge, UK.
J Plast Reconstr Aesthet Surg. 2007;60(6):607-14. doi: 10.1016/j.bjps.2006.11.005. Epub 2007 Jan 31.
Squamous cell carcinoma (SCC) of the temporal bone is a rare, aggressive and highly malignant tumour that requires specialised, multidisciplinary surgery for its treatment. Reconstruction of the defect is as crucial as the tumour ablation in terms of mortality and postoperative morbidity.
The experience of the East Anglian Skull Base Surgery Service from 1982 to 2004 in managing 42 consecutive patients (22 females; age range 37-80 years) undergoing extended and lateral temporal bone resection for SCC is presented.
The overall 5-year survival was 31.0% (median follow up: 97 months) when both curative and palliative procedures were included. On multivariate analysis, the favourable prognostic factors were male sex, well-differentiated tumours and stage N(0) neck. The reconstructions in 38 patients were analysed. The majority (24/38) had free tissue transfer reconstructions and most of these were radial forearm free flaps. Later in the series, other free flap types such as anterolateral thigh flaps and lateral arm flaps were employed. Pedicled myocutaneous flaps and local flaps were also used.
This paper analyses the outcomes of the various reconstructions and discusses the evolution of their care in our unit. The information obtained from the review of our data is extrapolated to offer guidance on the choice of reconstructive option in these patients.
颞骨鳞状细胞癌（SCC）是一种罕见、侵袭性强且高度恶性的肿瘤，其治疗需要专业的多学科手术。就死亡率和术后发病率而言，缺损的重建与肿瘤切除同样重要。
介绍了东盎格鲁颅底外科服务中心1982年至2004年连续管理42例因SCC接受扩大性和外侧颞骨切除术患者（22例女性；年龄范围37 - 80岁）的经验。
当包括根治性和姑息性手术时，总体5年生存率为31.0%（中位随访时间：97个月）。多因素分析显示，有利的预后因素为男性、高分化肿瘤和N(0)期颈部。对38例患者的重建情况进行了分析。大多数（24/38）采用了游离组织移植重建，其中大部分是桡侧前臂游离皮瓣。在该系列研究后期，还采用了其他游离皮瓣类型，如股前外侧皮瓣和上臂外侧皮瓣。也使用了带蒂肌皮瓣和局部皮瓣。
本文分析了各种重建的结果，并讨论了我们科室对其治疗的演变。从我们的数据回顾中获得的信息可用于为这些患者重建方案的选择提供指导。
