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经口入路使用超声刀通过内镜辅助切除舌根部良性病变

Endoscopy-Assisted Resection of Benign Lesions on the Base of the Tongue via the Transoral Approach Using a Harmonic Scalpel.

作者信息

Fan Song, Zhang Da-Ming, Chen Wei-Liang

机构信息

Lecturer, Department of Oral and Maxillofacial Surgery, Sun Yet-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Head and Professor, Department of Oral and Maxillofacial Surgery, Sun Yet-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Oral Maxillofac Surg. 2017 Oct;75(10):2242-2247. doi: 10.1016/j.joms.2017.03.002. Epub 2017 Mar 14.

Abstract

PURPOSE

Surgical removal of lesions from the base of the tongue can be challenging for head and neck surgeons. This study evaluated the clinical outcomes of patients with benign lesions at the base of the tongue who underwent endoscopy-assisted resection through the transoral approach using an ultrasonic harmonic scalpel.

PATIENTS AND METHODS

This retrospective observational study was conducted from May 2013 to January 2016. Data collected for each patient included age, gender, chief complaints, clinical symptoms, diagnostic imaging, complications after resection, and reported outcomes of resection. Diagnoses were made based on patient complaints, clinical symptoms, and computed tomography or magnetic resonance imaging. Diagnoses were confirmed by permanent pathologic sections.

RESULTS

Twelve patients with benign lesions on the base of the tongue were identified who had undergone endoscopy-assisted resection through the transoral approach using an ultrasonic harmonic scalpel. The patients had a mean age of 38.9 years. The benign lingual lesions consisted of lingual thyroid masses, squamous papillomas, schwannomas, pleomorphic adenomas, myoepithelioma, and lymphoid hyperplasia. Tumor size varied from 2.0 × 1.8 to 3.0 × 2.8 cm. All tumors were completely removed, and no complications occurred during or after surgery. The patients were followed for 6 to 30 months; 1 recurrence was found and was treated using a second endoscopy-assisted transoral resection.

CONCLUSIONS

Under endoscopic assistance, use of the harmonic scalpel through the transoral approach is a safe and feasible surgical technique for the removal of benign lesions at the base of the tongue.

摘要

目的

对于头颈外科医生而言,从舌根处手术切除病变可能具有挑战性。本研究评估了舌根良性病变患者经口入路使用超声谐波刀在内镜辅助下切除病变的临床效果。

患者与方法

本回顾性观察性研究于2013年5月至2016年1月进行。收集的每位患者的数据包括年龄、性别、主诉、临床症状、诊断性影像学检查、切除术后并发症以及报告的切除结果。诊断基于患者的主诉、临床症状以及计算机断层扫描或磁共振成像。诊断通过永久性病理切片得以证实。

结果

确定了12例舌根良性病变患者,他们经口入路使用超声谐波刀在内镜辅助下进行了切除。患者的平均年龄为38.9岁。良性舌部病变包括舌甲状腺肿物、鳞状乳头状瘤、神经鞘瘤、多形性腺瘤、肌上皮瘤以及淋巴组织增生。肿瘤大小从2.0×1.8厘米至3.0×2.8厘米不等。所有肿瘤均被完全切除,手术期间及术后均未发生并发症。对患者进行了6至30个月的随访;发现1例复发,通过第二次经口入路内镜辅助切除术进行了治疗。

结论

在内镜辅助下,经口入路使用谐波刀是一种安全可行的手术技术,可用于切除舌根良性病变。

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