舌骨区入路切除咽和喉恶性肿瘤

目的 探讨舌骨区入路切除咽喉恶性肿瘤的可行性及手术优势。方法 对1992年1月至2003年6月期间山东大学齐鲁医院经舌骨区入路肿瘤切除的53例患者进行了回顾性分析。结果 所有肿瘤视野暴露清晰，切除完整，术后病理证实切缘无残留。2例舌根受累者分别切除了舌下神经及舌动脉、喉上神经及喉上动脉：1例误伤喉上神经，其余全部予以保留。累及舌根者全部恢复了舌体运动、吞咽及言语功能。所有病例均进行随访，随访满3年和5年分别为46例和39例，无失访患者，3年和5年生存率分别为73．9％(34／46)和61．5％(24／39)。结论 舌骨区入路对舌会厌区、咽侧壁、咽后壁及会厌等肿瘤可以提供清楚直接的手术野，有效地减小创伤，是个良好的手术入路。

The clinical evaluation of regiones hyoidea access to resect pharyngeal and laryngeal carcinoma

JECTIVE To explore the feasibility and surgery advantage regiones hyoidea access to resect pha-ryngeal and laryngeal carcinoma.METHODS 53 cases with pharyngeal or laryngeal carcinoma with surgery of regiones hyoidea access was reviewed. RESULTS All the field of vision exposed clearly and the tumor were removed completely, it is also confirmed there is no residual tumor at the resection margin by postoperative pathology. The hypo-glossus and arteriae lingualis, nervi laryngeus superior and arteriae laryngeal superior invaded by tumor was respectively ablated of 2 cases, nervi laryngeus superior of another case was damaged by accidentally injure, the rest reserved the nerve and artery. The cases involved tongue base recovered the movement of tongue and all restored the swallow and speech function. The 3 and 5-year survival rate is 34/46(73.9 %) and 24/39(61.5 %).CONCLUSION To the cancer of the oropharyngeal glossal epiglottic region, pharyngeal side wall, paries posterion and epiglottis,rejiones hyoidea access can provide clear and direct operation view, decrease the trauma efficiently, it is good surgery access.