舌骨咽切开术治疗舌根癌

目的 探讨舌根癌外科治疗的最佳进路和方法。方法通过舌骨咽切开术治疗11例舌根癌,同期行会厌切除者4例,喉水平部分切除者1例。选择性颈清扫术1例,单侧功能性颈清扫术2例,双侧功能性颈清扫术1例,单侧根治性颈清扫术6例,一侧根治性和另一侧功能性颈清扫术1例。结果鳞状细胞癌10例,胚胎性横纹肌肉瘤1例;术后出现咽漏1例,进食流质轻度呛咳1例,上切缘阳性者1例,淋巴结转移者7例;术后拔管率100％;2、3、5年生存率分别为81.8％,77.8％,33.3％。结论 舌骨咽切开进路可清晰暴露舌根、会厌、下咽及喉部,适用于这些部位的肿瘤切除,并发症少。

The approach of transhyoid pharyngotomy for the base tongue carcinoma

Objective To study a better approach for resection the base tongue carcinoma. Methods Eleven patients with tongue base carcinoma were treated by surgery of the approach transhyoid pharyngotomy form 1993 to 2000. In the 11 patients with tongue base carcinoma resected, 4 cases were received epiglottecto-my, l case supraglottic horizontal partial laryngectomy, 1 case elective neck dissection, 2 cases unilateral modified radical neck dissection, 1 case bilateral modified radical neck dissection, 6 cases unilateral radical neck dissection and 1 case radical and modified radical neck dissection. There were 9 males and 2 females, ranging in age from 47 to 68 years old. Ten cases were squamous cell carcinoma and one case rhabdomyosarcoma. Results The de-cannulation rate was 100.0%, and the 2-year, 3-year and 5-year survival rate were 81.8%(9/11), 77.8%(7/9) and 33.3%(2/6), respectively. The incidence of complica-tions was 18%, including pharyngeal fistulas in 1, slight liquid food aspiration in l and positive surgical margin 1. Neck lymph node metastasis was 7. Conclusion The approach of transhyoid pharyngotomy can provide a good exposure and resect those tumors that involve the base of tongue, epiglottis, hypopharynx and larynx.