后壁口咽癌重建手术后恢复吞咽功能的病例报告

Q4 Medicine
Kenshi Iwanaga, A. Suehiro, Shin-ichi Sato, H. Tamaki, Koichi Omori
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引用次数: 0

摘要

虽然晚期口咽癌的治疗应考虑多学科治疗,包括切除和重建手术,但术后可能出现严重的吞咽困难,喉部保存可能很困难。后壁口咽癌比较少见,术后吞咽功能和预后较其他亚位差,但有关吞咽动力学的详细报道有限。在此,我们报告一位76岁的男性病例。他接受了口咽切除术,颈部清扫,环咽肌切开术治疗口咽后壁癌,并用大腿前外侧皮瓣重建。术后,患者出现严重的吞咽困难,但在大约2个月后恢复了吞咽需要咀嚼的食物的能力,并出院回家。术后大约4年半后,他仍然能够正常饮食,没有任何复发迹象。我们认为保留大部分舌骨上肌群和环咽肌切开术是维持吞咽功能的因素。此外,通过功能补偿,包括术后康复,建议喉保留以帮助口咽后壁癌患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A case report of swallowing function in a patient who resumed oral intake after reconstructive surgery for oropharyngeal cancer of the posterior wall
Although multidisciplinary treatment, including resective and reconstructive surgery, should be considered for the management of advanced oropharyngeal cancer, severe postoperative dysphagia may occur, and laryngeal preservation may be difficult. Oropharyngeal carcinoma of the posterior wall is rare and has a poorer postoperative swallowing function and prognosis than that of other subsites, but detailed reports on swallowing dynamics are limited. Here, we report the case of a 76-year-old man. He underwent resection of the oropharynx, neck dissection, cricopharyngeal myotomy for oropharyngeal posterior wall carcinoma, and reconstruction with an anterolateral thigh flap. After surgery, the patient presented severe dysphagia but recovered the ability to swallow food that required mastication in approximately 2 months, and was discharged home. After approximately 4.5 years post-surgery, he remains able to consume regular food without showing any recurrence. We believe that preservation of most of the suprahyoid muscle group and cricopharyngeal myotomy were factors for maintaining swallowing function. In addition, by focusing on functional compensation, including postoperative rehabilitation, laryngeal preservation is suggested to help patients with oropharyngeal posterior wall cancer.
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来源期刊
Japanese Journal of Head and Neck Cancer
Japanese Journal of Head and Neck Cancer Medicine-Otorhinolaryngology
CiteScore
0.10
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7
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