구강암의 수술적 접근법

Abstract

Background and ObjectivesZZIn the treatment of oral cancer, appropriate surgical approaches should be chosen in order to eradicate cancer while preserving the function of oral cavity and facial contour. This study was performed to evaluate the usefulness and effectiveness of various surgical approaches in the surgical treatment of oral cancer. Subjects and MethodZZA total of 112 oral cancer patients, excepting those with lip cancer, and who underwent surgery from 1994 to Aug 2008, were enrolled. We reviewed medical records retrospectively and analyzed the primary sites, stage, surgical approaches, management of mandible and neck, reconstruction methods, recurrence and survival rates. ResultsZZOf the 112 patients, 64 were transoral, 23 pull-through, 6 mandibular lingual releasing,6 upper cheek flap , 5 lower cheek flap , 6 mandibulotomy and 2 visor flap approach. Most of T1, T2 lesions could be resected by transoral (71.6%) or pull-through approach (21.0%). In the advanced T3, T4 lesions, transoral (21.9%), pull-through (37.5%), cheek flap (21.9%),mandibulotomy (15.6%) were used. There was no statistically significant difference with respect to locoregional recurrence and survival rate according to surgical approach. ConclusionZZThe transoral approach was the effective method for the surgery of T1, T2 and part of T3 oral cancer. The pull-through or mandibular lingual releasing approach was the effective method of surgery for T2, T3 tongue or floor of mouth (FOM) cancer while avoiding mandibulotomy. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:159-65