目的 :探讨治疗复发的鼻咽癌及晚期上消化道恶性肿瘤的外科手术切除和修复方法。方法 :对1例放疗复发的巨大晚期鼻咽癌采用上颌骨外旋进路切除肿瘤 +帽状腱膜滑行修复缺损 ;下颌骨外旋肿瘤切除 +胸大肌岛状肌皮瓣修复治疗 1例口咽部的扁桃腺癌 ;对晚期下咽及颈段食管癌各 1例行全喉全下咽或全食管切除后用胸大肌岛状肌皮瓣或胃代食管修复重建上消化道 ,术后再行Blom -Singer发音重建术。结果 :4例患者随访 2年均生存良好 ,鼻咽癌及扁桃腺癌患者术后保留了较好的外观 ,下咽癌及颈段食管癌患者发音效果满意。结论 :对晚期鼻咽癌和上消化道恶性肿瘤应积极行挽救性手术 ,术中注意功能的重建和保存 Objective : To explore the surgical resection and repair methods for recurrent nasopharyngeal carcinoma and advanced upper digestive tract malignancies. METHODS: One case of giant advanced nasopharyngeal carcinoma with radiotherapy recurrence was treated with maxillary external rotation to remove tumor and cap aponeurotic slide repair defect; Mandibular external rotation tumor resection and pectoralis major muscle island myocutaneous flap repair was used in one case. Oropharyngeal tonsillar carcinoma; 1 case of advanced hypopharyngeal and cervical esophageal cancer; 1 case was treated with total laryngeal hypopharyngeal or total esophageal resection. The upper gastrointestinal tract was reconstructed with pectoralis major muscle island myocutaneous flap or gastroesophageal esophagectomy. Postoperative Blom-Singer reconstructive surgery. Results: Four patients survived well for two years. Nasopharyngeal cancer and tonsil cancer patients retained good appearance after surgery. The hypoparyngeal cancer and cervical esophageal cancer patients had satisfactory results. Conclusion :Surgical salvage surgery should be actively performed for advanced nasopharyngeal carcinoma and upper gastrointestinal malignancies. Reconstruction and preservation of attentional function during surgery