下颌骨外旋咽、颅底肿瘤切除术4例报告

目的总结下颌骨外旋咽、颅底肿瘤切除术的体会.方法 4例咽及颅底肿瘤均采用下颌骨外旋入路进行手术切除.同期颈淋巴结清扫术2例,咽侧壁缺损以咽后壁局部黏膜转移修复2例.结果 3例恶性肿瘤完全切除;1例脊索瘤未完全切除,术后发生脑脊液鼻漏,填塞后痊愈.2例口咽癌中,1例术后1年死于局部复发,另1例术后2年10个月死于肺部转移.1例咽旁恶性混合瘤已术后3年2个月,仍在随访中.1例脊索瘤2年5个月死于颅内广泛转移.结论此手术入路能充分显露咽、中颅底、咽旁间隙、斜坡和颈椎,并能从颈部向上至颅底,将肿瘤完全切除,手术安全,后遗症轻微.

Mandibular swing procedure for resection of tumors in pharynx and skull base-A report of 4cases

Objective To sum up the experience in the operation of mandibular swing procedure (MSP)for resection of tumors in pharynx and skull base. Methods 4 cases with tumors in pharynx and skull base, 3 with malignancies and 1 with chordoma ,were all treated by MSP,simultaneously with neck dissection in 2 cases and the lateral wall reconstruction of oropharynx in another two. Results The malignancies of 3 cases were completely excised,with one survived for more than 3 years and being kept under following up now,while another two died of local reoccurrence or metastasis to the lung after one year and 26 months respectively following the operation. The case with chordoma was died 29 months after the operation because of widespread intracra-nial metastasis resulted from incompletely resection of the primary neoplasm during the operation. Conclusions This procedure provide good exposure to the pharynx,the base of skull,para-pharyngeal space,clivus as well as upper cerical vertebrae. It allows dissection along the internal carotid artery and resection of tumor en bloc with safety and minimal sequelae.