Zhao Yanming, Fang Jugao, Zhong Qi, Zhang Luo, Wang Chengsuo, Zhang Jiamin, Chen Jiaming, Feng Ling, He Shizhi, Ma Hongzhi, Hou Lizhen, Lian Meng, Shi Qian, Shen Xixi, Yang Yifan, Wang Ru
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Front Oncol. 2022 Aug 17;12:939404. doi: 10.3389/fonc.2022.939404. eCollection 2022.
To investigate a novel combined microinvasive trans-submandibular and nasendoscopy surgical approach for nasopharyngeal carcinoma involving the parapharyngeal space.
Seven patients diagnosed with nasopharyngeal carcinoma involving the parapharyngeal space between May 2018 and April 2021, two males and five females, aged 37-63 years.Six of the 7 patients underwent submental flap preparation and dissection of the lymph nodes in the upper neck and parapharyngeal space on the lesion side. The nasopharynx lesions and tumor margins were dissected under nasal endoscopy. The medial boundary of internal carotid artery separated by open cervical approach was used as the lateral boundary of the tumor to realize en bloc resection of the tumor.
The patients were preoperatively diagnosed with T2~3N0M0 nasopharyngeal carcinoma, including mucoepidermoid carcinoma (n=2), papillary adenocarcinoma (n=1), and nonkeratinizing squamous cell carcinoma (n=4). The tumors were removed completely, and patients achieved primary healing of the incision. No recurrence and no serious complications were recorded during the 13-48 month follow-up.
Complete resection of the tumor was obtained in the 7 patients without recurrence and serious complications during the follow-up. The findings of this cohort study suggest that, patients with recurrent nasopharyngeal carcinoma after radiotherapy and radiotherapy-insensitive types of nasopharyngeal carcinoma, the combined microinvasive trans-submandibular and nasendoscopy surgical approach may be considered as an surgical options. The results of this study provide an additional option for surgical treatment of NPC in the clinic.
探讨一种用于治疗累及咽旁间隙的鼻咽癌的新型联合微创经下颌下和鼻内镜手术入路。
2018年5月至2021年4月期间，7例被诊断为累及咽旁间隙的鼻咽癌患者，其中男性2例，女性5例，年龄37 - 63岁。7例患者中的6例进行了颏下皮瓣制备以及病变侧上颈部和咽旁间隙淋巴结的清扫。在鼻内镜下解剖鼻咽部病变及肿瘤边界。以开放颈部入路分离出的颈内动脉内侧边界作为肿瘤的外侧边界，实现肿瘤的整块切除。
患者术前诊断为T2~3N0M0鼻咽癌，包括黏液表皮样癌（n = 2）、乳头状腺癌（n = 1）和非角化性鳞状细胞癌（n = 4）。肿瘤均被完全切除，患者切口实现一期愈合。在13 - 48个月的随访期间，未记录到复发及严重并发症。
7例患者肿瘤均获完整切除，随访期间无复发及严重并发症。该队列研究结果表明，对于放疗后复发的鼻咽癌患者以及放疗不敏感型鼻咽癌患者，联合微创经下颌下和鼻内镜手术入路可作为一种手术选择。本研究结果为临床鼻咽癌手术治疗提供了一种额外的选择。
