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保留喉功能的 T2-3 期下咽后区癌的外科治疗。

Surgical treatment of T2-3 posterior hypopharyngeal carcinoma with preservation of laryngeal function.

机构信息

Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

Acta Otolaryngol. 2021 Sep;141(9):851-856. doi: 10.1080/00016489.2021.1965211. Epub 2021 Aug 30.

Abstract

BACKGROUND

Posterior hypopharyngeal carcinoma indicates a poor prognosis. Previous treatments predicted negative influence to the pronunciation and swallowing function. The present study focuses on improving survival rate while improving quality of life.

AIM

To investigate on the surgical techniques of the preservation of laryngeal function of posterior hypopharyngeal carcinoma.

METHODS

Eighteen patients with posterior hypopharyngeal carcinoma of T2-T3 were studied. All primary lesions were removed and the defects were repaired with the radial forearm free flap (RFFF).

RESULTS

The 3-year overall survival rate was 51.9%. All patients could maintain daily caloric intake by feeding orally, and remove the gastric tube 28-61 days after operation. Assessed swallowing function by Fiberoptic endoscopic evaluations of swallowing. When eating solid food, 66.67% patients had food residue; no food entered airway, and all patients had Penetration-Aspiration Scale of level 1. As for liquid, 11.11% patients had level 5, 16.67% level 4, 27.78% level 2 and 44.44% level 1.

CONCLUSIONS

By preserving the integrity of larynx and superior laryngeal nerve with repairing the defects of posterior wall of hypopharynx with RFFF, patients with T2 and T3 stage posterior hypopharyngeal carcinoma could live a better quality of life.

摘要

背景

咽后癌预后不良。既往治疗预测对发音和吞咽功能有负面影响。本研究旨在提高生存率的同时提高生活质量。

目的

探讨保留咽后癌喉功能的手术技术。

方法

研究了 18 例 T2-T3 期咽后癌患者。所有原发性病变均被切除,并用游离桡侧前臂皮瓣(RFFF)修复缺损。

结果

3 年总生存率为 51.9%。所有患者均能通过口服维持日常热量摄入,并在术后 28-61 天拔除胃管。通过纤维内镜吞咽评估评估吞咽功能。进食固体食物时,66.67%的患者有食物残留;无食物进入气道,所有患者的穿透-吸入量表均为 1 级。对于液体,11.11%的患者为 5 级,16.67%为 4 级,27.78%为 2 级,44.44%为 1 级。

结论

通过保留喉和喉上神经的完整性,并用 RFFF 修复咽后壁的缺损,T2 和 T3 期咽后癌患者可以提高生活质量。

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