1 Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
2 Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2018 Apr;158(4):645-648. doi: 10.1177/0194599817742856. Epub 2017 Nov 21.
The current standard of care in oral tongue cancer surgery is complete resection with a target of 5-mm microscopic clearance at all margins on final pathologic review. While current methods of resection are often successful at determining the mucosal margins of the lesion, they may be limited when attempting to achieve an adequate deep margin. A number of previous studies suggested that ultrasound is superior to manual palpation and other imaging modalities (computed tomography, magnetic resonance imaging) at demarcating the margins of tongue lesions. Recent clinical reports of the intraoperative use of this modality have used an invasive method to mark the proposed deep resection margin. In this communication, we report our initial experience with the use of intraoperative ultrasound as an adjunct to oral tongue cancer surgery without the use of an invasive method to mark the deep resection margin.
目前口腔舌癌手术的标准治疗方法是完全切除,最终病理检查时所有边缘的微观切缘均为 5mm。虽然目前的切除方法通常能成功确定病变的黏膜边缘,但在试图获得足够的深部切缘时可能会受到限制。许多先前的研究表明,超声在划定舌病变边缘方面优于手动触诊和其他影像学方法(计算机断层扫描、磁共振成像)。最近关于该方法术中应用的临床报告采用了一种侵入性方法来标记拟议的深部切除边缘。在本通讯中,我们报告了我们在不使用侵入性方法标记深部切除边缘的情况下,将术中超声作为口腔舌癌手术辅助手段的初步经验。