【摘要】 恰当地选择舌根癌外科手术进路，修复肿瘤切除后的缺损，对提高生存率、恢复并保存患者的语言、吞咽等功能是十分必要的。1987～1994年，对23例舌根鳞状细胞癌采取了经咽侧和经下颌骨切开的手术进路，用颈阔肌瓣一期修复舌根咽侧缺损。术后2、3、5年生存情况分别为20／23、13／16、4／7。语言及吞咽功能恢复良好，部分病人因术后放疗致口腔干燥而影响吞咽。根据肿瘤大小、侵袭范围选择手术进路才能充分显露肿物，便于彻底切除，又可避免不必要的损伤。颈阔肌瓣尽管修复面积有限，用于修复部分舌根、咽侧缺损，具有切取方便、距受区近、质地软、成活率高、并发症少等优点。更多还原

【Abstract】 Carcinoma of the base of the tongue is well-known to have a poor clinical prognosis. Between 1987 and 1994, 23 cases of squamous cell carcinoma of the base of the tongue were treated. The surgical approaches were suprahyoid pharyngotomy (13 cases, T1~4), and step-liked mandibulotomy (10 cases,T2~4). Functional or radical neck dissection and primary reconstruction of the base of the tongue with platysma muscle flap were performed on 9 patients. The importance of preoperative work-up was emphasized, which included careful palpation, direct/indirect laryngoscopy and evaluation by means of panoramic X-ray of the mandible, CT scanning and MRI. All patients maintained a good convalescence of speech. Dysphagia caused by xerostomia was found in some patients who were given adjuvant irradiation.更多还原