Jahnke V
Arch Otorhinolaryngol. 1975 Jul 8;210(2):275-91. doi: 10.1007/BF00460033.
Most carcinomas of the oral tongue and floor of the mouth are presently treated surgically, often combined with pre- or postopervative irradiation. The treatment plan is mainly determined by the primary site and the local and regional extension, desirable are general rules on the basis of the TNM classification. The indications and principles of the most important operative procedures are discussed: Local excision, partial glossectomy, excision of the floor of the mouth with marginal mandibulectomy, composite resection. Operations for removal of the primary and radical neck dissection with preservation of the mandible (e.g. the pull-through procedure) are rarely advised. A radical neck dissection is indicated in each carcinoma of the oral tongue or floor of the mouth with palpable lymph nodes. If no nodes are palpable, an elective neck dissection is advised in view of the high frequency of clinically occult lymph node metastases (between 23 and 43%). Reconstructive measures following radical tongue and floor of the mouth operations are required for regaining a motility of the remaining tongue, for reconstruction of the floor of the mouth and for replacement of the mandible.
目前，大多数舌癌和口底癌采用手术治疗，通常结合术前或术后放疗。治疗方案主要由原发部位以及局部和区域扩展情况决定，基于TNM分类的一般规则是可取的。讨论了最重要手术操作的适应证和原则：局部切除、部分舌切除术、口底切除联合下颌骨边缘切除术、复合切除术。很少建议采用保留下颌骨的切除原发灶及根治性颈清扫术（如牵拉式手术）。对于每例可触及淋巴结的舌癌或口底癌，均需进行根治性颈清扫术。如果未触及淋巴结，鉴于临床隐匿性淋巴结转移的高发生率（23%至43%），建议进行选择性颈清扫术。根治性舌和口底手术后需要采取重建措施，以恢复剩余舌的活动能力、重建口底以及替代下颌骨。
