36例外耳癌患者临床特征及诊治特点分析

Clinical Features and Surgery Methods of 36 Patients with External Ear Carcinoma

张国平;郑宏良;陈世彩;周义德;温武;郑贵亮;陈东辉;

1:第二军医大学附属长海医院耳鼻咽喉头颈外科

摘要

目的探讨外耳癌的临床特点、手术方法及预后。方法回顾性分析36例外耳癌的诊疗资料,其中耳廓癌13例,外耳道癌23例。11例耳廓癌行肿瘤局部切除,2例耳廓癌行部分或全耳廓切除+外耳道切除+腮腺切除及颈部淋巴结清扫术;1例Tis及4例T1外耳道癌患者行肿瘤局部切除,5例T1患者行外耳道软组织袖状切除;6例T2患者行外耳道软组织及骨壁整块切除+乳突切除术,如肿瘤侵犯外耳道周围软组织则加行腮腺浅叶切除;3例T3患者行颞骨外侧切除术+腮腺切除+腮腺区、颈ⅠⅤ区淋巴结清扫;4例T4患者行颞骨次全切除+腮腺切除+下颌关节切除术+腮腺区、颈ⅠⅤ区淋巴结清扫;4例T4患者行颞骨次全切除+腮腺切除+下颌关节切除术+腮腺区、颈ⅠⅤ区淋巴结清扫,创面以耳前带蒂皮瓣、耳后带蒂皮瓣、颞肌瓣、游离组织瓣修复。结果所有患者术后均未出现伤口延期愈合或皮瓣坏死情况。术后88.89%(32/36)的患者在不同程度上保留了患侧听功能,但晚期患者行放射治疗后,听力损失加重。随访5年,13例耳廓癌失访3例,无复发病例,仅1例因肺转移死亡;23例外耳道癌失访5例,8例复发,3年生存率77.78%(14/18)。结论耳廓癌早期易发现并彻底切除,预后较好;外耳道癌起病隐匿,早期易误诊,手术治疗越早,预后越好,术后听功能保存率高。

关键词

耳廓;外耳道;癌症;手术;听功能保留

基金项目(Foundation):

作者

张国平;郑宏良;陈世彩;周义德;温武;郑贵亮;陈东辉;

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