[Surgical therapy of oropharyngeal carcinoma within the scope of interdisciplinary tumor surgery].
BACKGROUND
The results of the surgical therapy of patients with extensive squamous cell carcinoma of the oropharynx and their lymph node metastasis, postoperative follow-up, and rehabilitation depend on the collaboration between ear, nose, and throat surgeons and maxillofacial surgeons. Modern reconstruction techniques permit single-session surgical treatment with a reduced period of hospitalization. The most important therapeutic aim is to improve patient well-being.


METHODS
Over a period of two years, 45 patients underwent the same surgical procedure. These patients were all in stages III or IV of their disease.


RESULTS
This procedure consists of a temporary lateral osteotomy of the mandible with or without resection of the mandible, to provide broad exposure of the tumor of the oropharynx. Apart from the broad exposure, the advantage of this surgical method lies in simple reconstruction using a pedicled and microanastomosed flap. Internal fixation with six and four-hole titanium plates is a reliable method for restoring the stability of the mandible. In six patients, complications occurred in connection with the plate fixation. In four patients, we observed osteomyelitis of the fragment fissure or sequestration. Plate fracture and pseudarthrosis occurred in one patient each.


CONCLUSIONS
In our clinical experience, the microvascular anastomosed radial flap proved to be the ideal free soft tissue transplant. One of its primary advantages is its plasticity and hence good post-therapeutic functional results. The jejunal flap has become less significant them the radial flap; the advantage of mucous membrane transfer is lost after radiation and a corresponding postoperative interval. In patients with large, voluminous defects, the use of myocutaneous flaps, especially from the latissimus dorsi, is still justified.
Esser
D
D
Univ.-Klinik für Hals-Nasen- und Ohrenheilkunde.
Erle
A
A
Begall
K
K
Freigang
B
B
D000328:Adult; D000368:Aged; D001860:Bone Plates; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D010348:Patient Care Team; D013524:Surgical Flaps / Q000379:methods
Die operative Therapie des Oropharynxkarzinoms im Rahmen der interdisziplinären Tumorchirurgie.