Li Ryan J, Richmon Jeremy D
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, 601 North Caroline Street, JHOC 6th Floor, Baltimore, MD 21287, USA.
Otolaryngol Clin North Am. 2012 Aug;45(4):823-44. doi: 10.1016/j.otc.2012.04.006.
Surgery of oropharyngeal cancer has evolved from large, open transcervical and transmandibular approaches to minimally invasive transoral endoscopic techniques. Transoral laser microsurgery and transoral robotic surgery allow complete oncologic resection through the mouth with minimal cosmetic deformity and optimal speech and swallow function. With a significant increase in the incidence of oropharyngeal cancers, there is a growing role for up-front surgery, especially in young, healthy patients with human papillomavirus-associated squamous cell carcinoma. This article explores the development of transoral endoscopic surgery, its role in the multidisciplinary treatment of patients with oropharyngeal cancer, and oncologic and functional outcomes.
口咽癌手术已从大型开放性经颈和经下颌骨入路发展为微创经口内镜技术。经口激光显微手术和经口机器人手术能够通过口腔实现完整的肿瘤切除,同时将美容畸形降至最低,并使言语和吞咽功能达到最佳状态。随着口咽癌发病率显著上升, upfront手术(新辅助手术或初始手术)的作用日益凸显,尤其是在患有与人乳头瘤病毒相关的鳞状细胞癌的年轻健康患者中。本文探讨了经口内镜手术的发展、其在口咽癌患者多学科治疗中的作用以及肿瘤学和功能学结果。