面部移位入路手术治疗侵及颅底的放疗后复发鼻咽癌

目的 探讨采用上颌骨翻转面部移位入路手术切除侵及颅底放疗后复发鼻咽癌的疗效及临床意义。方法 11例侵及颅底放疗后复发鼻咽癌，均采用上颌骨翻转面部移位入路手术切除。结果 11例患者均达到显微镜下肿瘤全切除。全部患者随访10-46个月，因肿瘤复发死亡2例，带瘤生存1例，其余患者均无肿瘤复发，生活质量良好。手术并发症包括：创腔感染1例：患侧听力下降、耳鸣各1例；张口受限1例。结论 上颌骨翻转面部移位入路手术切除侵及颅底复发鼻咽癌具有显露充分、肿瘤切除彻底的优点，其疗效满意，可作为放疗术后复发广泛侵及颅底的鼻咽癌的一种治疗选择。

Microsurgery through Transmaxillary Approach for Recurrent Nasopharyngeal Carcinoma Involving Cranial Base after Radiotherapy

Objective To study the curative effect of microsurgery through transmaxillary approach on postradiotherapeutic recurrent nasopharyngeal carcinoma and its clinical significance. Method Eleven patients with postradiotherapeutic recurrent nasopharyngeal carcinomas involving the cranial bases were treated by microsurgery through transmaxillary approach. Results The tumors were totally resected in all the patients. All the patients were followed up from 10 to 46 months (mean duration: 31.6 months). The tumors recurred in 3 patients, of whom, 2 died and 1 survived. The tumors did not recur in 8 patients who have good living quality. The postoperative complications included cut infection (1 case), tinnitus of the operative side (1 case), decrease in hearing of the operative side (1 case) and limitedly opening mouth (1 case). Conclusion The full exposure and total removal of tumor involving the cranial base may be achieved by microsurgery through transmaxillary approach, which is good method to remove recurrent nasopharyngeal carcinoma after the radiotherapy.