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扁桃体窝和腭弓的癌肿是口咽部最常见的肿瘤。它通常侵及颈上深部结构,亦可沿神经周围扩散至颅底。口咽癌患者中,其颈上或颈、二腹肌区淋巴结常先受害。当侵及软腭和咽后外侧壁时,才累及咽后淋巴结。Ballantyne指出,44咽壁癌肿有咽后淋巴结转移。它们位于上缩肌和椎前肌之间,分成两组淋巴结群,上外侧淋巴结群位于颅底,与颈内动脉孔和颈静脉孔相近;下内侧淋巴结群位于口咽部,直至上缩肌。因而,扁桃体癌肿向上扩展或浸及咽外侧壁时,须行颅底咽后淋巴结清扫术。综合切除术包括颈廓清术、下颌骨半切除、上颌骨后切除和颅底清扫术。手术在气管内插管麻醉下进行。用Frazier颈部改良切口(带有一颈阔肌下颈面皮瓣),行标准的颈廓清术,即胸
Tonsils of the tonsils and palatal fossa are the most common tumors of the oropharynx. It usually invading the deep structure of the neck, but also spread along the nerve to the skull base. Oropharyngeal cancer patients, the neck or neck, abdominal muscle area often suffer from lymph nodes. When the invasion of the soft palate and posterior pharyngeal lateral wall, involving the pharyngeal lymph nodes. Ballantyne pointed out that 44 pharyngeal wall cancer with retropharyngeal lymph node metastasis. They are located between the supra-sternal and anterior vertebral muscles and are divided into two groups of lymph nodes. The supra-lateral lymph node group is located at the base of the skull and is similar to the internal carotid artery and jugular foramen. The lower medial lymph node group is located in the oropharynx upwards, . Thus, tonsil cancer spread upward or dip and pharyngeal lateral wall, the line should be after the posterior radical lymph node dissection. Comprehensive resection includes neck dissection, submandibular resection, maxillary resection and skull base dissection. Surgery was performed under endotracheal intubation. Frazier neck modified incision (with a platysma neck flap), the standard neck dissection, the chest