Dil kökü kanserlerinde kombine suprahiyoid-transoral yaklaşım
Amaç: Erken evreli dil kökü kanserlerinde kombinesuprahiyoid-transoral yaklaflımın etkinliğini ve fonksiyonel sonuçlarını değerlendirmek.Hastalar ve Yöntemler: Dil kökü kanseri tanısı konan befl hasta kombine suprahiyoid-transoral yaklaflım ileameliyat edildi. Patolojik tanı üç olguda adenoid kistik karsinom, iki olguda yassı epitel hücreli karsinomfleklindeydi. İzlem süresi ortalama 32.4 ay dağılım10-54 ay idi.Bulgular: Adenoid kistik karsinomlu bir olguda, yassı epitel hücreli karsinomlu iki olguda boyun diseksiyonu yapıldı. Yassı epitel hücreli karsinomlu iki olguya ameliyat sonrasında radyoterapi uygulandı. Ameliyat sırasında tüm olgularda trakeotomi açıldı. Tümolgular ameliyat sonrası ortalama 11.4 günde dağılım 9-14 gün dekanüle edildi; ağızdan beslenmeyeortalama 8.6 günde dağılım 7-11 gün bafllandı vehiçbirinde aspirasyon olmadı. Cerrahi sınırlar tüm olgularda temiz bulundu. Tüm olgularda akıcı ve anlaflılabilir konuflma elde edildi. Takip süresi boyuncalokal veya bölgesel nüks görülmedi.Sonuç: T1veya T2dil kökü karsinomlarının cerrahitedavisinde kombine suprahiyoid-transoral yaklaflımın fonksiyonel sonuçları baflarılı bulundu
Anahtar Kelimeler:
Karsinom, skuamöz hücreli/cerrahi, kombine tedavi, hiyoid kemiği/cerrahi, mandibula/cerrahi, dil/cerrahi, dil neoplazmları/cerrahi/radyoterapi
Evaluation of the combined suprahyoid-transoral approach to the tongue base tumors
Objectives: To evaluate the efficacy and functional results of the combined suprahyoid-transoral approach in early-stage tongue base cancers.Patients and Methods: Five patients 4 females, 1 male; mean age 47 years; range 12 to 65 years with tongue base tumors undervvent surgery via the com bined suprahyoid-transoral approach. Diagnoses were adenoid cystic carcinoma in three patients and squa- mous celi carcinoma in two patients. The mean follow- up period was 32.4 months range 10 to 54 months .Results: One patient with adenoid cystic carcinoma and two patients with squamous celi carcinoma required neck dissection. Postoperative radiotherapy was administered to two patients with squamous celi carcinoma. Tracheotomy was performed in ali cases during surgery. AH patients were safely decannulated within a mean of 11.4 days range 9 to 14 days and converted to oral feeding within a mean of 8.6 days range 7 to 11 days with no aspiration problem. AH patients had negative surgical margins. AH patients had satisfactory phonation. No local or regional recurrences developed during the follow-up period.Conclusion: Functional results obtained through the combined suprahyoid-transoral approach justify its use in the treatment of T, or T2 tongue base carcinomas.
Keywords:
Carcinoma, squamous cell/surgery, combined modality therapy, hyoid bone/surgery, mandible/surgery, tongue/surgery, tongue neoplasms/surgery/radiotherapy,
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- Civantos F, Wenig BL. Transhyoid resection of tongue base and tonsil tumors. Otolaryngol Head Neck Surg 1994;111:59-62.
- Nasri S, Oh Y, Calcaterra TC. Transpharyngeal approach to base of tongue tumors: a comparative study. Laryngoscope 1 9 9 6 ; 1 0 6 : 9 4 5 - 5 0 .
- Marchetta FC, Sako K, Murphy JB. The periosteum of the mandible and intraoral carcinoma. Am J Surg 1971; 122:711-3.
- Eisen MD, Weinstein GS, Chalian A, Machtay M, Kent K, Coia LR, et al. Morbidity after midline mandibulotomy and radiation therapy. Am J Otolaryngol 2000;21:312-7.
- Agrawal A, Wenig BL. Resection of cancer of the tongue base and tonsil via the transhyoid approach. Laryngoscope 2000;110:1802-6.
- Alperin KM, Levine HL, Wood BG, Tucker HM. Approach to and reconstruction for lesions of the pos- terior third of the tongue via midline labiomandibular glossotomy. Head Neck Surg 1984;6:744-50.
- Weber PC, Johnson JT, Myers EN. The suprahyoid approach for squamous cell carcinoma of the base of the tongue. Laryngoscope 1992;102:637-40.
- Moore DM, Calcaterra TC. Cancer of the tongue base t reated by a transpharyngeal approach. Ann Otol Rhinol Laryngol 1990;99(4 Pt 1):300-3.
- Zeitels SM, Vaughan CW, Ruh S. Suprahyoid pharyngo- tomy for oropharynx cancer including the tongue base. A rch Otolaryngol Head Neck Surg 1991;11 7 : 7 5 7 - 6 0 .
- Weber PC, Myers EN, Johnson JT. Squamous cell carc i- noma of the base of tongue. Eur Arch Otorh i n o l a r y n g o l 1 9 9 3 ; 2 5 0 : 6 3 - 8 .
- Kraus DH, Vastola AP, Huvos AG, Spiro RH. Surgical management of squamous cell carcinoma of the base of the tongue. Am J Surg 1993;166:384-8.
- G o l d e n b e rg D, Ardekian L, Rachmiel A, Peled M, Joachims HZ, Laufer D. Carcinoma of the dorsum of the tongue. Head Neck 2000;22:190-4.
- Imamoglu M, Iflik AU, Bahadir O, Muhtar H. Surgical treatment of oral cavity cancers. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 1999;6:203-5.
- Baflerer N, Cavanflir B, Kıyak E, Hafız G, Mirata D, Üstündağ E. Dil kökü ve orofarenks tümörlerinde Set- Back tekniği ile rekonstrüksiyon. Kulak Burun Bogaz Ihtis Derg 1992;1:6-10.
- ISSN: 2602-4837
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1991
- Yayıncı: İstanbul Üniversitesi