Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Head Neck. 2011 Feb;33(2):166-70. doi: 10.1002/hed.21415.
The transoral approach to the parapharyngeal and retropharyngeal space (PPS/RPS) for the management of well-differentiated thyroid carcinoma (WDTC) has been previously described in other articles. However, limited exposure with this approach can be a challenge.
This is a retrospective review of 6 patients who underwent ultrasound-guided transoral excision of PPS/RPS WDTC metastases from October 2003 to March 2009 in a cancer center setting. Ultrasound-guided methylene blue dye injection of the node was used in 3 patients to facilitate intraoperative identification. The technique, safety, and feasibility of the procedure are described in this study.
Successful resection of the metastases was accomplished in all cases without intraoperative complication. The 1 definite recurrence was further treated with transmandibular excision.
Transoral excision of PPS/RPS WDTC metastases with ultrasound-guided methylene blue dye injection into the metastatic node is safe, feasible, and may further improve intraoperative identification of metastases in poorly accessible locations in the head and neck.
经口入路切除咽旁和咽后间隙（PPS/RPS）用于治疗分化型甲状腺癌（WDTC）在其他文章中已有描述。然而，该方法的应用经验有限，存在一定难度。
本研究回顾性分析了 2003 年 10 月至 2009 年 3 月在癌症中心接受超声引导下经口切除 PPS/RPS WDTC 转移灶的 6 例患者的临床资料。其中 3 例患者采用超声引导下美蓝染料注射辅助术中识别。本文描述了该技术的方法、安全性和可行性。
所有患者均成功切除转移灶，术中无并发症。1 例确诊复发患者进一步接受经下颌骨切除术治疗。
超声引导下美蓝染料注射入转移性淋巴结行经口切除 PPS/RPS WDTC 转移灶安全、可行，并可能进一步提高对头颈部难以触及部位转移灶的术中识别能力。
