Zhang H K, Li J, Jiang X W, Li S, Xue K, Sun X C, Liu Q, Gu Y, Li W P, Song X L, Yu H M
Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.
Department of Otorhinolaryngology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Jan 7;58(1):21-27. doi: 10.3760/cma.j.cn115330-20220708-00426.
To describe a technique of endoscopic transoral approach nasopharyngectomy for petroclival and jugular foramen nasopharyngeal carcinoma, based on anatomic studies and surgeries. Three dry human skulls and five fresh human cadaver heads were used for anatomic study of a endoscopic transoral approach to expose petroclival and jugular foramen. The anatomical landmarks and the extent of exposure were recorded. Six clinical cases who were treated in Eye & ENT Hospital, Fudan University from June 2020 to April 2022 were used to illustrate the technique and feasibility of this approach and to assess its indications and advantages, including 3 males and 3 females, aged 42 to 69 years old. Descriptive analysis was used in this research. On the basis of the preservation of the internal pterygoid muscle and the external pterygoid muscle, this approach could fully expose the parapharyngeal, petrosal and paraclival segment internal carotid arteries, and safely deal with the lesions of jugular foramen and petroclival region. The 6 patients in our study tolerated the procedure well. Postoperative enhanced MRI showed complete resection of the tumor and no postoperative masticatory dysfunction. Endoscopic transoral approach is a safe, minimally invasive and effective surgical treatment for petroclival and jugular foramen recurrent nasopharyngeal carcinoma.
基于解剖学研究和手术实践，描述一种用于岩斜区和颈静脉孔区鼻咽癌的内镜经口入路鼻咽切除术技术。使用三个干燥人头骨和五个新鲜人体尸头进行内镜经口入路暴露岩斜区和颈静脉孔的解剖学研究。记录解剖标志和暴露范围。选取2020年6月至2022年4月在复旦大学附属眼耳鼻喉科医院接受治疗的6例临床病例，以说明该入路的技术和可行性，并评估其适应证和优势，其中男性3例，女性3例，年龄42至69岁。本研究采用描述性分析。在保留翼内肌和翼外肌的基础上，该入路可充分暴露咽旁、岩骨段和岩斜段颈内动脉，并安全处理颈静脉孔区和岩斜区病变。本研究中的6例患者对手术耐受性良好。术后增强磁共振成像显示肿瘤完全切除，且无术后咀嚼功能障碍。内镜经口入路是治疗岩斜区和颈静脉孔区复发性鼻咽癌的一种安全、微创且有效的手术方法。
