[经口及颈部入路无需下颌骨切开术治疗口咽癌并采用桡侧前臂游离皮瓣重建术]
[Transoral and cervical approach without mandibulotomy for oropharynx cancer with fasciocutaneous radial forearm free flap reconstruction].
作者信息
Bozec A, Poissonnet G, Chamorey E, Sudaka A, Laout C, Vallicioni J, Demard F, Dassonville O
机构信息
Département de chirurgie, institut universitaire de la face et du cou, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.
出版信息
Ann Otolaryngol Chir Cervicofac. 2009 Sep;126(4):182-9. doi: 10.1016/j.aorl.2009.06.002.
OBJECTIVE
To evaluate the role of a combined transoral and cervical approach without mandibulotomy for surgery of oropharyngeal cancer with fasciocutaneous radial forearm free flap reconstruction.
MATERIAL AND METHODS
All patients who underwent this type of surgery between 2003 and 2007 were included in this retrospective study. We analyzed postoperative outcomes, surgical margins (histological study) and the oncological and functional results.
RESULTS
A total of 24 patients were included in this study. There was no free flap failure. Surgical margins were negative for 23 of the 24 patients. At 3 years, overall, cause-specific, and disease-free survival rates were 73, 76 and 68%, respectively. A good functional result (normal or slightly impaired function) was obtained for oral diet, speech, mouth opening and esthetic outcome in 78, 82, 92 and 86% of the patients, respectively.
CONCLUSION
This double surgical approach without mandibulotomy in selective cases can replace the transmandibular approach in locally advanced oropharyngeal cancer surgery.
目的
评估不进行下颌骨切开术的经口联合颈部入路在采用桡侧前臂游离皮瓣重建的口咽癌手术中的作用。
材料与方法
本回顾性研究纳入了2003年至2007年间接受此类手术的所有患者。我们分析了术后结果、手术切缘（组织学研究）以及肿瘤学和功能结果。
结果
本研究共纳入24例患者。未出现游离皮瓣失败情况。24例患者中有23例手术切缘为阴性。3年时，总体生存率、特定病因生存率和无病生存率分别为73%、76%和68%。分别有78%、82%、92%和86%的患者在经口进食、言语、张口和美学效果方面获得了良好的功能结果（功能正常或轻度受损）。
结论
在选择性病例中，这种不进行下颌骨切开术的双重手术入路可替代局部晚期口咽癌手术中的经下颌入路。
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