口咽癌或口腔癌患者的部分下颌骨切除术无骨重建

T. Schrom, F. Bast, S. Knipping
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引用次数: 3

摘要

研究目的:口腔肿瘤的切除对口腔的功能和美学特性有重要的影响。外科技术和微血管手术的进步使重建结果达到术前水平,具有良好的功能和美观效果。然而,重建的选择并非没有并发症。材料和方法我们报告了23例口腔或口腔底大肿瘤患者的结果,他们切除了肿瘤和部分下颌骨而没有骨重建。患者群体包括19例口咽癌和4例口底癌,均为cT4期(6例女性和17例男性),患者平均年龄为59.8岁。测量术前和术后的开口能力、咀嚼疼痛程度、术前和术后的咀嚼功能以及术后的审美结果。结果患者从美观、功能、镇痛等方面均满意。全面的术前准备工作是必要的,与多学科团队的讨论是必要的。这种治疗方案比预期的更容易被患者接受,并提供了令人满意的功能和美学结果。因此,我们认为不进行骨重建的部分下颌骨切除术是一种可接受的治疗选择,对于那些精心挑选的可能不适合进行骨重建的广泛手术的患者。
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Partial mandibulectomy without bony reconstruction in patients with oropharyngeal or mouth cancer
Aim of the study Resection of tumours of the oral cavity has significant consequences relating to function and aesthetic properties. Advancements in surgical techniques and microvascular surgery have enabled reconstructive outcomes to reach those of pre-surgery levels with good functional and aesthetic results. However, reconstructive options are not without complications. Material and methods We report the outcome of 23 patients with large tumours of the oral cavity or floor of the mouth, who underwent resection of the tumour and parts of the mandible without bony reconstruction. The patient population consisted of 19 oropharyngeal carcinomas and four floor of the mouth cancers, all of which had stage cT4 (six female and 17 male patients), and with an average patient age of 59.8 years. The pre- and postoperative ability to open the mouth, level of pain while masticating, mastication function pre and post-surgery, and the aesthetic outcome post-surgery were measured. Results The results obtained were deemed pleasantly acceptable by the patients, from aesthetic, functional, and analgesic points of view. Discussion A thorough preoperative work up is required and discussion with a multidisciplinary team is a necessity. This treatment option is more acceptable to the patient than would be expected and provides a satisfactory functional and aesthetic outcome. Therefore, we believe that partial mandibulectomy without bony reconstruction is an acceptable management option for a carefully selected group of patients who may not be suitable for the extensive surgery involved with bony reconstruction.
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