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鼻内镜辅助联合经口入路切除侵犯鼻腔及鼻窦的腭部癌

[Nasal endoscopy assisting combined with transoral approach for resection of carcinoma of the palate invading nasal cavity and sinuses].

作者信息

Tan Pingqing, Huang Wenxiao, Chen Jie, Tan Haolei, Zhong Waisheng, Peng Fusen, Zhang Hailin

机构信息

Department of Head and Neck Surgery,Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya Medical School,Central South University,Changsha,410013,China.

Department of Otorhinolaryngology Head and Neck Surgery,Loudi Central Hospital.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar;36(3):194-197. doi: 10.13201/j.issn.2096-7993.2022.03.008.

Abstract

To explore the value of nasal endoscopy assisting combined with transoral approach in resection of the carcinoma of the palate with the nasal cavity and sinuses invaded. A retrospective analysis of 21 patients with a primary malignant tumors of the palate was performed. Preoperative nasal endoscopy and CT and MRI scan showed that the primary tumors invading the nasal cavity and sinuses in all patients or skull base with varying degrees. All patients were treated by nasal endoscopic assisting combined with transoral approach. Postoprational adjuvant radiotherapy or concurrent chemoradiotherapy was performed according to pathological types and clinical stage. Postoperative complications, all-tumor resection rate, local control rate and 5-year survival rate were analyzed statistically. The combined approach was successfully performed in all patients. En bloc resection was carried out in 18 patients by this combined approach and surgical margins were free of carcinoma. The median follow-up period was 60 months. All patients had good nasal ventilation function and no epiphora in postoperation, and the overall local control rate of primary site was 85.7%, overall 5-year survival rate was 76.2%. Nasal endoscopy assisting combined with transoral approach is an effective method for the resection of palate malignant tumors invading the nasal cavity and sinuses. It is convenient for en bloc resection and local control of primary lesions. It is beneficial to preserve the function of nasal cavity and sinuses, which is in line with the principle of functional surgery.

摘要

探讨鼻内镜辅助联合经口入路切除侵犯鼻腔鼻窦的腭部癌的价值。对21例原发性腭部恶性肿瘤患者进行回顾性分析。术前鼻内镜及CT、MRI检查显示所有患者原发肿瘤均不同程度侵犯鼻腔鼻窦或颅底。所有患者均采用鼻内镜辅助联合经口入路治疗。根据病理类型和临床分期进行术后辅助放疗或同步放化疗。对术后并发症、全肿瘤切除率、局部控制率和5年生存率进行统计学分析。所有患者均成功实施联合手术。采用该联合手术方式18例患者实现整块切除,手术切缘无癌残留。中位随访时间为60个月。所有患者术后鼻腔通气功能良好,无溢泪,原发部位总体局部控制率为85.7%,总体5年生存率为76.2%。鼻内镜辅助联合经口入路是切除侵犯鼻腔鼻窦的腭部恶性肿瘤的有效方法。便于整块切除及局部控制原发灶。有利于保留鼻腔鼻窦功能,符合功能外科原则。

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