鼻咽癌救援性手术新进路的探讨_上颌骨_鼻内翻进路切除术_郭翔.pdfVIP

5癌症61998 年第 17 卷第 4 期 271 # 临床研究 # 鼻咽癌救援性手术新进路的探讨 )) ) 上颌骨- 鼻内翻进路切除术 郭 翔 闵华庆 黄晓明 张锦明 陈福进 v 钱朝南 摘 要 目的: 探讨鼻咽原发癌救援性外科治疗的新进路。材料与方法: 6 例鼻咽癌放疗后鼻咽复发患者, 采用 上颌骨- 鼻内翻进路切除鼻咽复发癌。结果: 6 例鼻咽癌放疗后隐窝或侧壁的复发癌, 经上颌骨- 鼻内翻后, 能够充 分显露鼻咽及相邻的部分鼻咽旁组织, 进行根治性手术切除, 手术切缘病理均为阴性。术后伤口按期愈合, 且口腔功 能不受影响。术后随访 1 年未见复发。结论: 上颌骨- 鼻内翻进路能够充分暴露鼻咽及鼻咽旁间隙, 将鼻咽及扩展到 鼻咽旁和鼻腔的癌瘤根治性切除; 该进路也可用于鼻咽其它肿瘤或颅底肿瘤的手术切除。 主题词 鼻咽肿瘤/ 外科手术 上颌骨- 鼻内翻进路/ 方法 中图号 R739. 63 R730. 56 Study on new approach of salvage surgery in nasopharyngeal carcinoma )) ) the maxillary- nasal medial swing approach for resection of nasopharyngeal carcinoma Guo Xiang Min Huaqing Huang Xiaoming, et al Department of NPC, Cancer Center, Sun Yat-sen University of Medical Science, Guangzhou, 510060 Abstract Objective: To study new approach of salvage surgery in resection of primary lesion of nasopharyngeal carcinoma. Method: Six cases of locally recurrent nasopharyngeal carcinomas after radiotherapy were operated by the maxillary-nasal medial swing approach to resect the primary lesions. Results: In all of six cases of recurrent nasopha- ryngeal carcinomas in the fossa of Rosenmuller or in lateral walls of nasopharynx after radiotherapy, the whole nasopharynx and paranasopharyngeal space were fully exposed by the maxillary- nasal medial swing approach. Oncological resection of tumor in all cases were performed without any pathological evidence of residual tumor in resection margins. After opera- tion, the wounds healed primarily in all cases without influence of oral function. No recurrence occurred in o