论文部分内容阅读
目的:介绍一种晚期舌癌术后复发侵犯高位颈动脉的外科治疗方法。方法:先行暴露颅外骨组织,用圆钻磨去1cm岩骨段(C5)。用Shunt管行颈总一颈内动脉分流,肿瘤组织行扩大切除(肿瘤连同颈动脉切除),同时行大隐静脉移植重建颈动脉。最后用胸大肌带蒂肌皮瓣修复口内外组织缺损。结果:术后2周TCD检查大脑前、中动脉的血流速度与术前相近,术后4周颈动脉B超显示血流通畅,术后随访未出现神经并发症。结论:该手术可行,而且安全,为该类被视为不治之症的患者提供了治愈的机会。
Objective: To introduce a surgical treatment for the recurrence of advanced tongue cancer after invading the high carotid artery. METHODS: Exposed extracranial bone tissue was first exposed and a 1 cm section of the petrous bone (C5) was removed using a circular drill. A Shunt tube was used to perform a total internal carotid artery shunt. The tumor tissue was extensively resected (tumor together with a carotid artery resection) and a large saphenous vein was grafted to reconstruct the carotid artery. Finally, pectoralis major myocutaneous flaps were used to repair intraoral and external tissue defects. RESULTS: The blood flow velocity of the anterior and middle cerebral arteries was similar to that of preoperative TCD examination at 2 weeks after operation. B-ultrasonography showed smooth blood flow at 4 weeks after operation. No neurological complications were observed after follow-up. Conclusion: This procedure is feasible, safe, and provides a cure for patients who are considered incurable.