구인두암의 수술적 접근법

Abstract

Background and Objectives In order to eradicate the disease and preserve function of oropharynx and facial contour, appropriate surgical approach should be chosen for surgical treatment of oropharyngeal cancer. This study was performed to evaluate the usefulness and effectiveness of various surgical approaches in the surgical treatment of oropharyngeal cancer. Subjects and Method We analyzed 65 patients with oropharyngeal cancer who underwent surgery as a primary treatment from Jan. 1994 to Jun. 2009, retrospectively. Primary tumor site, TNM stage, surgical approach, management of neck, reconstruction method, complication, recurrence rate were analyzed to assess advantages and disadvantages of various surgical approaches. Results The surgical approaches applied were transoral approach in 25, mandibulotomy in 23, lower cheek flap in 4, trans-pharyngeal in 9, and mandibular lingual releasing approach in 4. Most of T1 lesion was resected by transoral approach (65.0%). For advanced T3 and T4, mandibulotomy was mainly used. Lateral pharyngotomy and mandibular lingual release approach were used for the surgery of moderate size of oropharyngeal cancer. The locoregional recurrence rate did not differ according to different surgical approaches with regard to T and N stages. Conclusion Transoral approach is very useful for the most of small oropharyngeal cancer. Mandibulotomy provides most wide surgical view for advanced T3, T4 oropharyngeal cancer.