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目的:探讨梨状窝癌侵犯喉结构的规律,为保留喉功能的梨状窝癌的手术治疗提供病理学依据。方法:应用石蜡包埋大体标本连续切片的方法,对26例梨状窝癌全喉及次全喉切除的标本进行了研究。结果:位于梨状窝内侧壁的肿瘤容易向喉腔扩展,声门旁间隙及甲状软骨是最易受侵犯的喉结构,环状软骨受侵较少;会厌及会厌前间隙的侵犯未见超过中线,声门旁间隙及会厌前间隙的侵犯途径有两个,肿瘤沿杓会厌襞向前及在甲状软骨板内侧直接向前侵犯声门旁间隙;肿瘤沿杓会厌襞向内上方及在甲状软骨板内侧上部侵入会厌前间隙。结论:声门旁间隙及会厌前间隙的受侵并不是喉部分切除的禁忌证,大部分位于梨状窝外侧壁的肿瘤及部分梨状窝内侧壁的肿瘤保留喉功能是可行的。
Objective: To investigate the rule of invasion of laryngeal structures in pear-shaped fossa carcinoma and to provide the pathological evidence for the surgical treatment of laryngeal fossa carcinoma with laryngeal function. Methods: A total of 26 specimens of complete or full laryngeal carcinoma of the popliteal carcinoma were studied by serial paraffin embedded sections. Results: The tumor located in the inner wall of the pyriform socket extended easily to the laryngeal cavity. The paraxial space and thyroid cartilage were the most vulnerable laryngeal structures with less involvement of the cricoid cartilage. The epiglottis and epiglottic anterior gap did not surpass the midline, There are two ways in which the periosteal space and the anterior epiglottis encroach on the glottis. The tumors invade the supraglottic space along the peroneal epiglottis and forward directly on the medial thyroid cartilage. Medial upper part of the invasion of epiglottis gap. CONCLUSIONS: Periosteal glottavas and the anterior epiglottis gap are not contraindications to laryngectomy. Most of the tumor located in the lateral wall of the fossa pallidum and some of the inner wall of the piriform fossa are viable.