晚期喉部鳞状细胞癌对喉上、下神经的侵袭:一个病例系列和回顾。

IF 0.7 Q4 OTORHINOLARYNGOLOGY
Avinash Shekhar Jaiswal, Sumanth Bollu, Shilpi Budhiraja, Seema Kaushal, Kapil Sikka, Alok Thakar, Hitesh Verma
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引用次数: 0

摘要

目的:探讨双侧喉上、喉返神经与晚期喉癌手术患者肿瘤扩散的关系。方法:前瞻性研究包括活检证实的喉鳞状细胞癌(SCC),计划全喉切除术。异时性或同步性SCC患者被排除在研究之外。所有患者均行全喉切除术,随标本切除喉上神经和喉返神经,并标记近端神经以供参考。评估肿瘤内神经和双侧喉外神经的围神经侵犯(PNI)。结果:研究纳入22例患者,平均年龄58岁。22例中有7例(32%)发现肿瘤内PNI。从近端到远端检查喉上神经和喉返神经游离缘,均未见肿瘤浸润。结论:神经周围侵及小神经是传播的主要途径。相反,侵犯喉上神经或喉返神经并不构成肿瘤扩散的途径。因此,没有必要扩大全喉切除术的手术范围,以分别包括这些主要神经。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review.

Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review.

Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review.

Perineural Invasion of Superior and Inferior Laryngeal Nerves in Advanced Stage Squamous Cell Carcinoma of the Larynx: A Case Series and Review.

Objective: To evaluate bilateral superior and recurrent laryngeal nerves for tumor spread in patients of advanced-stage laryngeal carcinoma undergoing surgical resection.

Methods: A prospective study was conducted including biopsy-proven cases of laryngeal squamous cell carcinoma (SCC) that were planned for total laryngectomy. Patients with metachronous or synchronous SCC were excluded from the study. All patients underwent total laryngectomy, where both superior and recurrent laryngeal nerves were harvested along with the specimen, and the proximal ends of the nerves were marked for reference. Perineural invasion (PNI) was assessed in nerves within the tumor and in bilateral extra-laryngeal nerves.

Results: The study included 22 patients with a mean age of 58 years. Intra-tumoral PNI was found in 7 of the 22 cases (32%). The free nerve margins of superior and recurrent laryngeal nerves, which were examined from proximal to distal orientation, showed no tumor infiltration in any of the cases.

Conclusion: Perineural invasion of minor nerves constitutes a major pathway of spread. On the contrary, invasion of superior or recurrent laryngeal nerves does not constitute a route for tumor spread. Hence, there is no need to extend the surgical boundary for total laryngectomy to include these major nerves separately.

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