小涎腺肿瘤的外科治疗

目的:分析和探讨小涎腺肿瘤的临床特征和诊疗要点。方法:对我院1997～2004年收治的54例小涎腺肿瘤患者的临床特征和治疗效果作回顾性分析。结果:54例患者中失访16例,在随访到的38例患者中,因肿瘤复发死亡4例,其中2例鼻腔腺样囊性癌分别于术后2年和3年死于肿瘤复发,1例喉肌上皮癌术后3年死于肿瘤复发,1例鼻窦黏液表皮样癌术后1年5个月死于肿瘤复发;2例鼻窦腺样囊性癌术后复发,再次手术后无瘤生存;1例鼻腔腺样囊性癌术后11个月复发,行伽玛刀治疗及中药治疗带瘤生存;其余患者均无瘤生存。结论:小涎腺肿瘤分布广泛,病理类型繁多,本组病例以恶性肿瘤多见,占81.4%。不同部位的肿瘤和不同病理类型的肿瘤临床表现和治疗方案各不相同。对良性肿瘤多采用肿瘤摘除术。而对恶性肿瘤治疗,手术结合放疗是主要的治疗方案。成功的关键是完整地切除肿瘤和有足够的切缘。

Surgical management of minor salivary gland tumors

Objective:To study the clinical features of minor salivary gland tumors and to discuss the treatment modalities for these tumors.Method:Retrospective analysis of 54 cases with minor salivary gland tumor operated in our hospital from 1997 to 2004.Result:Among 54 cases with minor salivary gland tumors in this series,16 patients lost of follow up.Among the remaining 38 patients,2 patients with nasal cavity adenoid cystic carcinoma died of tumor recurrence 2 and 3 years after the surgery respectively,one patient with laryngeal myoepithelial carcinoma died of tumor recurrence 3 years after the surgery and one patient with paranasal sinus mucoepidermoid carcinoma died of recurrence 17 months after the surgery.Two patients with paranasal sinus adenoid cystic carcinoma recurred after the primary surgery and were survived without tumor after salvage surgery.The other patients survived with no tumor recurrence.Conclusion:While different histopathology of minor salivary gland tumors were found in this group,malignant tumors were predominant,accounting for 81.4%.The choice of treatment for minor salivary gland tumors depends upon the location and the histopathology of the tumors.The treatment policy for benign tumors is simple tumor excision,while that for malignant tumors is surgery combined with pre-or post-operative radiation therapy.Complete surgical resection of tumor masses and tumor free margin is essential for successful treatment of malignant minor salivary gland tumors