Leipzig B, Johnson J T, Rabuzzi D D
J Otolaryngol. 1979 Feb;8(1):60-4.
While composite resection remains the fundamental surgical approach to carcinoma of the posterior oral cavity, removal or reconstruction of the adjacent segment of mandible remains contentious. Various grafts have been used with less than satisfactory and unpredictable results. Bone has been brought in, borrowed, reshaped, and implanted into the area of mandibular deficit; mandibular osteotomy has been attempted with primary closure as well. A review of 78 composite resections at Upstate Medical Center reveals that of this number, 61 have undergone primary lateral mandibulectomy without reconstruction while four others have undergone more extended resection without reconstruction at the time of initial surgery. In the others, mandibular reconstruction has been unsatisfactory; mandibular osteotomy in the presence of irradiated tissue has been unsuccessful in all cases. In our experience, satisfactory results, functionally and cosmetically, have been attained with partial mandibulectomy and primary closure of the wound obviating more involved reconstructive procedures. A review of therapy with attention to surgical detail, complications, and results is presented.
虽然联合切除术仍然是口腔后部癌的基本手术方法，但下颌骨相邻节段的切除或重建仍然存在争议。已经使用了各种移植物，但结果不尽人意且难以预测。骨已被引入、借用、重塑并植入下颌骨缺损区域；也尝试过下颌骨截骨术并进行一期缝合。对纽约州北部医学中心的78例联合切除术进行回顾发现，其中61例接受了一期外侧下颌骨切除术且未进行重建，另外4例在初次手术时接受了更广泛的切除且未进行重建。在其他病例中，下颌骨重建效果不佳；在有放疗组织的情况下进行下颌骨截骨术在所有病例中均未成功。根据我们的经验，通过部分下颌骨切除术和伤口一期缝合避免了更复杂的重建手术，在功能和美观方面都取得了满意的结果。本文介绍了对治疗方法的回顾，重点关注手术细节、并发症和结果。
