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环杓软骨水平下咽后壁癌切除及重建术中应用咽后壁瓣的病例报告

A case report of application of posterior pharyngeal flap in resection and reconstruction of posterior pharyngeal wall carcinomas located at the level of the cricoid cartilage.

作者信息

Li Lianhe, Zou Liangyu, Fang Jugao

机构信息

Central Hospital of Chaoyang, Liaoning.

Chengde Medical College, Hebei.

出版信息

Medicine (Baltimore). 2019 Feb;98(7):e14412. doi: 10.1097/MD.0000000000014412.

Abstract

RATIONALE

posterior pharyngeal wall carcinomas located at the level of the cricoid cartilage is a rare occurrence. Surgical treatment is a dilemma owing to the retention of laryngeal function PATIENT CONCERNS:: A 56-year-old man underwent a "resection of left cervical tumor" at another hospital. Postoperative pathological report noted a left metastatic squamous cell carcinoma of the neck. Neck-enhanced computed tomography (CT) revealed thickening of the right posterior pharyngeal wall, and an image of soft tissue density was present on the posterior pharyngeal wall with a size of approximately 1.0 × 1.5 cm.

DIAGNOSIS

Hypopharyngeal carcinoma (T1N2M0).

INTERVENTIONS

We performed operation on a patient who suffered from posterior pharyngeal wall carcinomas at the level of the cricoid cartilage. The postoperative defects were repaired with posterior pharyngeal flaps.

OUTCOMES

The patient with posterior pharyngeal flap after operation survived without necrosis, the neck wounds of patient healed in 1 stage, and the phonation, swallowing and respiratory function was good.

LESSONS

The application of posterior pharyngeal flap to repair defects due to posterior pharyngeal wall carcinomas that were located at the level of the cricoid cartilage after resection is an effective reconstruction method that is easy to use and has excellent repair effects.

摘要

理论依据

位于环状软骨水平的下咽后壁癌较为罕见。由于要保留喉功能,手术治疗存在两难困境。

患者情况

一名56岁男性在另一家医院接受了“左颈部肿瘤切除术”。术后病理报告显示为左颈部转移性鳞状细胞癌。颈部增强计算机断层扫描(CT)显示右下咽后壁增厚,下咽后壁有软组织密度影像,大小约为1.0×1.5厘米。

诊断

下咽癌(T1N2M0)。

干预措施

我们对一名患有环状软骨水平下咽后壁癌的患者进行了手术。术后缺损采用下咽后壁瓣修复。

结果

术后采用下咽后壁瓣的患者存活且无坏死,患者颈部伤口一期愈合,发声、吞咽及呼吸功能良好。

经验教训

应用下咽后壁瓣修复环状软骨水平下咽后壁癌切除术后的缺损是一种易于实施且修复效果良好的有效重建方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8885/6408051/ed7d290a8823/medi-98-e14412-g001.jpg

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