Zeitels S M, Vaughan C W
Department of Otology and Laryngology, Harvard Medical School, Boston, MA.
Am J Otolaryngol. 1994 May-Jun;15(3):197-203. doi: 10.1016/0196-0709(94)90005-1.
Cancer in the tongue base, which is adjacent to or invading the lingual epiglottis, requires resection of part or all of the larynx to assure adequate surgical margin. Based on whole mount laryngeal sections, a tongue base-partial supraglottic laryngectomy procedure was designed for tumors adjacent to or minimally invading the lingual epiglottis.
A group of five patients with carcinoma of the tongue base adjacent to or minimally invading the lingual epiglottis was identified. This technique requires excision of the epiglottis, hyoepiglottic ligament, and pre-epiglottic space with the lesion. The structural physiological integrity of the false vocal cords with or without the hyoid bone is preserved.
Clear tumor margins were obtained in all five patients. In three patients who required up to 50% resection of the tongue base, decannulation and resumption of a full oral diet was achieved. Two patients with more extensive lesions required 70% resection of the tongue base. Both patients underwent completion laryngectomy months later because of persistent aspiration.
This preliminary report suggests that partial supraglottic laryngectomy may be used with acceptable functional results in patients with limited tongue base lesions.
舌根癌若毗邻或侵犯会厌舌面，则需切除部分或全部喉以确保足够的手术切缘。基于喉部连续切片，针对毗邻或微侵会厌舌面的肿瘤设计了一种舌根 - 部分声门上喉切除术。
确定了一组5例毗邻或微侵会厌舌面的舌根癌患者。该技术要求连同病变一并切除会厌、舌会厌韧带和会厌前间隙。保留真假声带及舌骨的结构生理完整性。
所有5例患者均获得了清晰的肿瘤切缘。3例舌根切除达50%的患者实现了拔管并恢复正常经口饮食。2例病变范围更广的患者舌根切除达70%。由于持续误吸，这2例患者数月后均接受了全喉切除术。
这份初步报告表明，部分声门上喉切除术用于治疗病变局限的舌根癌患者，其功能结果尚可接受。
