经口腔机器人手术治疗头颈癌的初步经验

该文旨在研究经口腔机器人手术（TORS）治疗头颈部恶性肿瘤的技术可行性、安全性及有效性。对应用daVinci外科机器人治疗的20例患者进行前瞻性研究。纳入标准为成年患者的早期头颈癌，包括口腔癌、口咽癌、下咽癌及喉癌。结果，2例无法充分达到手术部位，手术终止。其他18例术后手术切缘阴性。8例行组织重建。10行单侧颈淋巴清扫，5例行双侧颈清，未行气管切开，术中、术后无并发症。     

<手术创新与意外处理>口腔颌面外科卷出版

北京医科大学口腔医学院马大权、俞光岩教授主编的《手术创新与意外处理》口腔颌面外科卷已由吉林科学技术出版社于 2 0 0 0年 1月出版。全书 76余万字 ,46 0余幅图。本书反映出 2 0世纪90年代口腔颌面外科新进展、新成就以及某些创新及改良术式。书中介绍了有关手术的操作技术 ,手术意外的预防和处理 ,并对手术术式进行评价。可供口腔颌面外科、耳鼻喉科、头颈外科临床医师以及有关研究生应用参考《手术创新与意外处理》口腔颌面外科卷出版@米长才     

9例经口入路机器人手术在口腔颌面外科应用报道

目的: 总结口腔颌面外科机器人手术的应用经验。方法: 解放军总医院口腔科应用达芬奇机器人手术系统对9例位于口腔深部肿瘤患者行经口入路机器人手术（transoral robotic surgery, TORS）,总结手术经验与体会。结果: 患者均顺利完成手术,摆位及术区暴露用时20~90 min,平均42.2 min;手术时间5~90 min,平均40.9 min。除1例双侧颈淋巴清扫术患者外,其余纯口腔入路患者8例,术后平均住院日3.25 d,术后均顺利出院,平均住院天数7.75 d。结论: 达芬奇机器人手术系统可以独立完成口腔深部肿瘤手术,但在特殊患者如舌根肿瘤手术上仍有一定困难,主要是术区暴露时间较长。     

中国口腔颌面肿瘤学进展50年

20世纪 5 0年代以前 ,中国口腔医学尚未建立 ,因而没有一支从事口腔颌面肿瘤的专业队伍 ;2 0世纪 5 0年代 ,随着口腔医学事业的发展在一些有独立建制的口腔颌面外科单位才陆续开展了口腔颌面肿瘤的诊治工作。当时由于专门从事头颈肿瘤的单位为数寥寥 ,也为口腔颌面外科医师在诊治口腔颌面肿瘤提供了一个广阔的创业天地。至 1986年 ,我国成立第一个头颈肿瘤外科学术组织———中国抗癌协会头颈外科专业委员会时 ,已基本形成了一支较完整的从事口腔颌面肿瘤诊治与研究工作的专业队伍。在由头颈外科医师、耳鼻咽喉科医师及口腔颌面外科医师共同…     

我国口腔颌面-头颈肿瘤外科的历史、内涵及发展

头颈肿瘤涵盖了口腔颌面部肿瘤。由于口腔颌面部的解剖结构及功能的复杂性，肿瘤切除手术对患者容貌的重大影响等因素，决定了头颈肿瘤治疗中具有鲜明特色，口腔颌面外科在治疗口腔颌面-头颈肿瘤中具有不可替代的作用。     

第三届全国头颈肿瘤外科学术会议在沪召开

由中国抗癌协会头颈肿瘤外科专业委员会主持的第三届全国头颈肿瘤外科学术会议于1991年5月21日～23日在上海召开,来自28个省、市、自治区的口腔颌面外科、耳鼻咽喉科、头颈肿瘤外科以及有关的360余名代表和日本、荷兰的学者参加了这次学术盛会。大会共收到论文522篇,其中244篇作了大会专题报告和交流发言。大会表明我国的头颈部肿瘤的治疗已从单纯手术根治发展到目前的根治性与功能整复相结合阶段,国内教学医院及省级医院均能对舌癌、喉癌、下咽癌等患者,进行手术根治的同时进行器官重建或再造,以恢复呼吸、进食、语言     

肩胛旁游离皮瓣在头颈部整复中的应用

作者应用肩胛旁游离皮瓣一期重建头颈癌术后组织缺损29例,文章阐述了手术设计和操作技术,皮瓣总成活率为93%。该皮瓣用途广泛,已成为作者重建头颈     

机器人辅助颈淋巴清扫术的应用进展

机器人辅助手术因具有较传统微创技术更加可视、精确、灵活的优势而越来越广泛地应用于临床。颈淋巴清扫术作为头颈外科的经典术式之一,近年来也有单位开始在机器人辅助下对其进行尝试。本文就机器人手术的现状,机器人辅助颈淋巴清扫术的不同手术入路的应用进展、不足与前景等作一综述。     

《口腔颌面-头颈外科手术学》出版发行

由上海交通大学医学院附属第九人民医院·口腔医学院邱蔚六院士主编的《口腔颌面-头颈外科手术学》(书号:ISBN:978-7-5337-6623-8)一书,2014年12月由安徽科学技术出版社出版发行。该书共21章,约106万字,图1350余幅。内容求新求精。除介绍基本手术操作和手术方法外,还着重收入了有关整复外科、显微外科、内镜外科、导航外科,以及介入手术、阻塞性睡眠呼吸障碍手术等内容,以利发挥和推广     

仿真内窥镜在头颈外科中的应用

仿真内窥镜是近年来迅速发展的影像学技术,通过计算机处理三维影像数据,模拟器官管腔内的结构,获得类似内窥镜下的视野。仿真内窥镜在临床影像学诊断、术前计划、影像导航手术、医学教学和临床培训等领域具有广阔的应用前景。本文就仿真内窥镜在头颈外科中的应用作一综述。     

Transoral robotic surgery of parapharyngeal space tumours: a series of four cases

Tumours arising from the parapharyngeal space (PPS) represent less than 1% of all head and neck tumours. Salivary gland tumours account for 40–50% of PPS lesions and are located in the pre-styloid parapharyngeal space. Pleomorphic adenomas represent 80–90% of salivary tumours in the PPS. Recently, transoral robotic surgery (TORS) has become common in head and neck surgery as a minimally invasive procedure. Four cases of benign PPS tumour treated with TORS are presented here. Preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging, and the results were used to plan the correct surgical approach. One case required a change of approach to conventional transoral blunt dissection. Patients required pain control and reported dysphagia symptoms for a period of weeks, but no nasogastric tube was needed at any time. This case series indicates that TORS is a safe surgical procedure for the excision of benign tumours of the PPS in selected cases.     

Robotic surgery in oral and maxillofacial,craniofacial and head and neck surgery: A systematic review of the literature

A systematic review of the literature concerning robotic surgery in oral and maxillofacial (OMF), craniofacial and head and neck surgery was performed. The objective was to give a clear overview of the different anatomical areas of research in the field of OMF, craniofacial and head and neck surgery, in all its fields (pre-clinical and clinical). The present indications are outlined and the critical reader is invited to assess the value of this new technology by highlighting different relevant parameters. A PubMed and Cochrane library search yielded 838 papers published between 1994 and 2011. After screening the abstracts, 202 articles were considered clinically or technically relevant and were included. These full papers were screened in detail and classified as articles on synopsis (n = 41), educational aspects (n = 3), technical/practical aspects (n = 11) and clinical papers (n = 147). Regarding clinical feasibility this systematic review revealed the following main indications: transoral robotic surgery (TORS) for upper digestive and respiratory tract lesions; TORS for skull base surgery; and TORS for trans-axillary thyroid and endocrine surgery. Regarding functional outcome, this systematic review revealed a promising reduction of morbidity in patients with cancer of the upper digastric and respiratory tract.     

Current applications of ultrasound-guided wire localization in head and neck surgery

Ultrasound-guided wire localization (USGWL) was originally developed for the removal of impalpable breast lesions. More recently, USGWL has been described in head and neck surgical practice and it has a number of applications in this field, with the potential to guide surgical exploration and the benefits of reducing operative time and morbidity. This technical note describes the use of preoperative USGWL to facilitate the removal of an impalpable neck node. A review of the current literature relating to the present applications of this technique in head and neck surgery is reported, highlighting its advantages and disadvantages.     

Advances and innovations in computer-assisted head and neck oncologic surgery

Over the past years, computer-assisted surgery has gained more importance in craniomaxillofacial surgery, especially in primary and secondary treatment of head and neck malignancies. The basis for oncologic treatment of the head and neck region requires detailed planning using computed tomography, cone-beam computed tomography, or magnetic resonance imaging in combination with computer-assisted, infrared-based navigation system. These techniques allow a preplanned image-guided path to the tumor region for taking biopsies, resection, or reconstruction. The aim of this work was to show the advances and technical benefits for tumor surgery in a daily clinical routine from the view of the craniomaxillofacial surgeon. The target of our working group was to develop and clinically evaluate a novel three-dimensional planning and navigation software solution for treatment of craniofacial tumors. This work was carried out on 5 categories for oncologic surgical procedures in which computer-assisted surgery was applied from 2005 to 2011: preplanned trajectorial-guided tumor biopsy, intraoperative image-controlled tumor resection, tumor mapping, reconstruction after tumor surgery (true to original), and oral rehabilitation (backward planning). Successful preoperative planning, import of image data suitable for navigation, and intraoperative precise infrared-based navigation were obtained for all 5 categories without any complications. Image-guided navigation technique for head and neck oncologic surgery provides a precise, safe surgical method with real-time excellent anatomic orientation. Regarding the advantages of computer-assisted surgery, this technique will play a major part in craniofacial reconstructive surgery and will address widespread general methodologic solutions that are of great interest in multidisciplinary oncologic treatment.     

Sir Henry Trentham Butlin: the father of British head and neck surgery

Sir Henry Butlin was our first pioneer in head and neck surgery. Though the man himself has been all but lost to history, surgeons in the UK and the USA are returning to the technique of selective neck dissection that he first described over a century ago.     

Additional direct medical costs associated with nosocomial infections after head and neck cancer surgery: a hospital-perspective analysis

The clinical impact of surgical site infections (SSI) and postoperative pneumonia (PP) after head and neck cancer surgery has been assessed in the past, but little is known about their economic impact. The present study was designed to evaluate costs related to SSI and PP after head and neck cancer surgery with opening of mucosa. The incidence of SSI and PP was measured in a prospective cohort of 261 patients who had undergone head and neck cancer surgery. The additional direct medical costs related to these infections from the hospital perspective were determined based on postoperative length of stay. The mean direct hospital costs for patients with and without SSI or PP were compared. Of the 261 patients, 81 (31%), 21 (8%) and 13 (5%) developed SSI, PP or both, respectively. The additional lengths of stay attributable to SSI, PP or both were 16, 17 and 31 days, respectively, and additional direct medical costs related to these conditions were 17,000, 19,000 and 35,000 Euros. Nosocomial infections after head and neck cancer surgery significantly increase patients' length of stay and therefore generate additional direct medical costs. These results support the application of preventive interventions to reduce nosocomial infections in this setting.     

Role of PET/CT in maxillo-facial surgery

PET/CT has an established and key role in the management of squamous cell carcinoma of the head and neck. It should be considered in all patients with occult head and neck tumours and before major interventions particularly in those patients with a high risk of distant metastases. This article outlines the physical principles of the technique and illustrates the clinical applications in maxilllo facial surgery.     

Role of robotic surgery in oral and maxillofacial, and head and neck surgery

We review the current status of robotic surgery in the head and neck region and its role in oral and maxillofacial surgery.     

以颈横动脉供血的延长锁骨上岛状皮瓣修复头颈部恶性肿瘤术后缺损

应用于头颈部缺损修复的皮瓣多种多样,包括局部皮瓣、带蒂皮瓣和游离组织瓣。其中带蒂皮瓣具有容易切取、颜色及质地较好、手术时间短、并发症少等优点而被广泛应用。锁骨上区是一个重要的皮瓣供区,肩部皮肤提供了理想的可修复头颈外科缺损的皮肤组织。颈侧三角区主要的锁骨上血管是颈横动脉,目前罕有以颈横动脉供血的延长至肩部皮肤的锁骨上岛状皮瓣修复头颈部恶性肿瘤术后缺损的报道。本文对此方面内容作一评价。