[Combined therapy of advanced tonsillar squamous cell carcinoma and one-stage repair of the defect].
OBJECTIVE
To evaluate the treatment of advanced squamous cell carcinoma of the tonsil.


METHODS
Eight patients with advanced tonsillar carcinoma underwent resections combining mandibular ramus and oral cavity approaches, neck dissection and one-stage repair of the defect with pectoralis major myocutaneous flap (PM). The managements were supplemented with preoperative chemotherapy and postoperative radiotherapy.


RESULTS
Following up 3 to 9 years, 6 of 8 cases(75%) survived for more than 3 years. Two of 8 cases (25%) died of different causes postoperatively. One case died of serious hemorrhage resulted from radio-mandibulomyelitis 3 months after operation, and the other case died of esophageal carcinoma 2 years after operation. Two cases complicated radio-mandibulomyelitis. Two cases suffered from temporary regurgitation of food to the nasal chamber.


CONCLUSIONS
Through this combined approach, the advanced tonsillar carcinoma could be resected en bloc under direct visual field and keeping 1-1.5 cm safe margin to the tumor. Neck dissection, preoperative chemotherapy and postoperative radiotherapy were supplemental measures. Combined therapy was of great significance in reducing recurrence of the tumor. PM was usually survived and easily obtained, hence, suitable for repairing the pharyngeal defect.
Xiao
Wenhui
W
Department of Otorhinolaryngology, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China. xiaowenhui@etang.com
Yi
Zixiang
Z
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery; D013524:Surgical Flaps; D014067:Tonsillar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*