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目的 探讨舌骨区入路切除咽喉恶性肿瘤的可行性及手术优势。方法 对1992年1月至2003年6月期间山东大学齐鲁医院经舌骨区入路肿瘤切除的53例患者进行了回顾性分析。结果 所有肿瘤视野暴露清晰,切除完整,术后病理证实切缘无残留。2例舌根受累者分别切除了舌下神经及舌动脉、喉上神经及喉上动脉;1例误伤喉上神经,其余全部予以保留。累及舌根者全部恢复了舌体运动、吞咽及言语功能。所有病例均进行随访,随访满3年和5年分别为46例和39例,无失访患者,3年和5年生存率分别为73.9％(34／46)和61.5％(24／39)。结论 舌骨区入路对舌会厌区、咽侧壁、咽后壁及会厌等肿瘤可以提供清楚直接的手术野,有效地减小创伤,是个良好的手术入路。
Objective To investigate the feasibility and surgical advantages of hyoid bone area resection of throat malignancy. Methods A retrospective analysis was performed on 53 patients who underwent excision of the hyoid tract from Qilu Hospital of Shandong University from January 1992 to June 2003. Results All tumors had a clear field of vision, complete resection and no residual residual margin after surgical pathology. Two cases of tongue base involvement were removed the sublingual and lingual arteries, the laryngeal nerve and the laryngeal artery; 1 case of injury to the laryngeal nerve, the rest were all retained. Tongue involved all restored tongue movement, swallowing and speech function. All patients were followed up for 3 and 5 years respectively. 46 cases and 39 cases were followed up. The 3-year and 5-year survival rates were 73.9% (34/46) and 61.5% (24/39), respectively. . Conclusions The hyoid area can provide a clear and direct surgical field for the tongue epiglottis area, the pharyngeal side wall, the posterior pharyngeal wall and the epiglottis. It is a good surgical approach to effectively reduce the trauma.