改进功能性颈淋巴清扫术在头颈恶性肿瘤治疗中的应用

本文报道我科改进功能性颈淋巴清扫术107例，其中10例为双侧同期手术，获得满意效果．术式改进方法为将斜方肌上部前缘垂直切口设计呈“双曲”形，使术后伤口疤痕由直线收缩改为曲线收缩，进一步改善了颈部的外形及功能，术中采用胸锁乳突肌游离法，隧道式颈大块切除，保存了该肌的完整性，避免了术后肌肉僵硬萎缩；本组病例中89例保留了耳大神经，免除了患者耳廓及周围皮肤终生麻木的痛苦，并提出在实施功能性颈淋巴清扫术时应增加“4保留”原则，使这一术式更趋完善，以达到临床最佳效果．

Improvement of Functional Neck Dissection on the Malignant Tumor of Head and Neck

The essay reperted 107 cases in which FND was performed. Among them,10 cases weredone on both sides of neck contemporarily. The result was satisfactory. The design of the operation wasdifferent from the conventional one and had been improved in three aspects. First, the incision on thefrontal edge of the upper part of the trapezius was designed as double curves, which inade it possible tochange the scar-after-operation from straight contraction to curved contraction that the appearance of theneck would be more acceptable and muscular function be better reserved. Second, the rigidity andatrophy of the sternocl eidomastoid muscle were avoided by means of intreducing the disconnexion tothe sternocleidomastoid muscle and making tunnel dissection to the great cervical mass. Third, the greatauricular nerve was reserved during the operation so that the anesthesia happend at the skin around the.auriculae would be avoided. In so, the new concept four reservations was suggested in the application ofFND