头颈部肿瘤,尤其是鳞状细胞癌,在其发生远隔转移之前就有局部广为扩散的可能。这种病人发生死亡时而肿瘤仍局限于头颈部而无远隔转移。因此要切实切除肿瘤,必须连同可能以各种方式发生局部扩散的各部分一起切除。在局部扩散方式中,骨管内沿神经周围扩散就是其一。但这都常被人们所忽视或在许多教科书中都来曾提到。在1967年Maccomb和Fletcher曾介绍上颌窦癌向上扩散到上颌神经并向后扩散至蝶腭神 Head and neck tumors, especially squamous cell carcinomas, may have widespread local spreads before they undergo distant metastases. When this patient died, the tumor was still limited to the head and neck without distant metastases. Therefore, the actual removal of the tumor must be excised together with the parts that may have localized diffusion in various ways. In the local diffusion mode, the diffusion around the nerve in the bone tube is one of them. But this is often overlooked by people or mentioned in many textbooks. In 1967, Maccomb and Fletcher described that maxillary sinus cancer diffuses up to the maxillary nerve and spreads back to the chrysalis.