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目的 :探讨晚期扁桃体癌的手术治疗方式及术后缺损的 期修复。方法 :对 7例晚期扁桃体癌患者 ,除 1例行改良颈清扫术外 ,余均行根治性颈清扫术 ,经口腔及咽侧进路肿瘤切除各 1例 ;经颈 -颌 -扁桃体联合进路肿瘤切除 5例 ,其中 3例采用前臂桡侧游离皮瓣 期修复 ,2例采用胸大肌肌皮瓣 期修复。结果 :经颈 -颌 -扁桃体联合进路肿瘤切除 ,并采用组织皮瓣修复的 5例 ,术后随访 1～ 5年 3个月 ,均健在 ,无肿瘤复发 ,功能恢复满意 ;经口腔及咽侧进路切除肿瘤的 2例 ,术后 2个月及 8个月肿瘤复发 ,分别于术后 1年及 2年 10个月死亡。结论 :对晚期扁桃体癌手术治疗宜取颈 -颌 -扁桃体联合进路肿瘤切除术式 ;同时 ,宜用前臂桡侧游离皮瓣或胸大肌肌皮瓣修复。
Objective: To investigate the surgical treatment of advanced tonsillar carcinoma and the repair of postoperative defects. Methods: Seven patients with advanced tonsillar carcinoma were treated with radical neck dissection except for one case of modified neck dissection. One case was resected by oral cavity and pharyngeal approach. One case was treated by neck-jaw-tonsil union Five patients had tumor resection, of which 3 were treated with free radial forearm flap repair and 2 with pectoralis major myocutaneous flap repair. Results: The tumors were resected by the combined approach of neck - jaw - tonsil and were repaired by tissue flap. All the patients were followed up for 1 to 5 years and 3 months. All of them were alive without tumor recurrence and the functional recovery was satisfactory. Tumor resection was performed in 2 cases. Tumor recurrence occurred at 2 months and 8 months after operation. The patients died at 1 year and 2 years and 10 months respectively. CONCLUSIONS: It is advisable to take the neck-jaw-tonsil approach in the surgical treatment of advanced tonsillar cancer. At the same time, it is better to use the radial forearm free flap or the pectoralis major myocutaneous flap for repair.