Krespi Y P, Sisson G A
Arch Otolaryngol. 1982 Nov;108(11):681-4. doi: 10.1001/archotol.1982.00790590003002.
We extended the limits of standard jaw and neck dissection in large tumors of the oropharynx with extension to the soft and hard palate. Resection of the primary tumor with adequate margins and the lymphatics of the infratemporal fossa is required for tumor control in these extensive lesions. Splitting the lip in the midline and developing a large cervicofacial flap gives an excellent exposure to the region. The resection includes the hemimandible and the soft tissues of the intratemporal fossa. The internal carotid artery is followed to the skull base and all structures medial to this vessel, including the cartilaginous portion of the eustachian tube and the external carotid, are included in the en bloc specimen. The resection of the posterior maxilla, pterygoid plate, and palate may vary according to tumor size. The surgical defect is usually reconstructed with a pectoralis myocutaneous flap.
对于侵犯软腭和硬腭的口咽大型肿瘤，我们扩大了标准颌颈清扫术的范围。对于这些广泛病变，为控制肿瘤，需切除具有足够切缘的原发肿瘤及颞下窝的淋巴管。沿中线劈开唇部并掀起大型颈面皮瓣可充分暴露该区域。切除范围包括半侧下颌骨及颞下窝的软组织。追踪颈内动脉至颅底，该血管内侧的所有结构，包括咽鼓管软骨部和颈外动脉，均包含在整块切除标本中。后上颌骨、翼突板和腭部的切除可根据肿瘤大小有所不同。手术缺损通常用胸大肌肌皮瓣修复。
