山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (2): 17-20.doi: 10.6040/j.issn.1673-3771.1.2019.012

• 专家笔谈 • 上一篇    下一篇

鼻内镜手术治疗首诊局部晚期鼻咽癌及放疗后严重并发症的作用

邱前辉1,*(),陈卓2   

  1. 1. 南方医科大学珠江医院耳鼻咽喉科，广东 广州 510282
    2. 郑州大学第一附属医院耳鼻咽喉科，河南 郑州 450052
  • 收稿日期:2019-01-31 出版日期:2019-03-20 发布日期:2019-03-28
  • 通讯作者: 邱前辉 E-mail:qiuqianhui@hotmail.com
  • 作者简介:邱前辉，医学博士，教授，主任医师，博士生导师。南方医科大学珠江医院耳鼻咽喉科主任。主要学术任职：中国医疗保健国际交流促进会过敏科学分会副主任委员，中华医学会变态反应学分会委员，中国中西医结合学会耳鼻咽喉科专业委员会变态反应专家委员会副主任委员，中国中西医结合学会耳鼻咽喉科专业委员会鼻颅底肿瘤和嗅觉专家委员会副主任委员，广东省医学会变态反应学分会主任委员，广东省医师协会变态反应工作委员会学术顾问，广东省医师协会耳鼻咽喉科医师分会鼻科专业组副组长，广东省医学会肿瘤学分会鼻咽癌学组组员，广东省医学会耳鼻咽喉科学分会鼻科学组组员，广东省自然科学基金、中国博士后基金、省医学科研基金评审专家。主要研究方向：鼻腔鼻窦炎症性疾病及颅底肿瘤的基础和临床研究。在广东省较早开展过敏性鼻炎过敏原检测和特异性免疫治疗，是国内首位开展变应性鼻炎标准化抗原冲击免疫治疗的专家，同时也是国内较早开展内镜下鼻窦炎手术以及内镜鼻颅底肿瘤手术的专家之一。主持国家和省部级课题15项，发表论文80余篇

Endoscopic surgery for the treatment of locally advanced nasopharyngeal carcinoma and serious complications after radiotherapy

Qianhui QIU1,*(),Zhuo CHEN2   

  1. 1. Department of Otorhinolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong, China
    2. Department of Otorhinolaryngology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
  • Received:2019-01-31 Online:2019-03-20 Published:2019-03-28
  • Contact: Qianhui QIU E-mail:qiuqianhui@hotmail.com

RichHTML

6

PDF (PC)

642

摘要：

随着鼻内镜技术的不断提高，其已逐渐成为鼻咽癌综合治疗中的重要方式之一。就首诊局部晚期鼻咽癌的手术治疗、鼻咽癌放疗后严重并发症放射性骨坏死的内镜手术治疗及内镜手术在未来鼻咽癌治疗中可能的发展前景等方面进行综述。

关键词: 鼻咽肿瘤, 放射治疗, 并发症, 鼻内镜外科手术

Abstract:

With the improvement in endoscopic techniques, endoscopy has gradually become an important approach for the comprehensive treatment of nasopharyngeal carcinoma. This article reviews the literature on the surgical treatment of locally advanced nasopharyngeal carcinoma and the endoscopic surgical treatment of radioactive necrosis, a severe complication of radiotherapy for nasopharyngeal carcinoma. Prospects for the development of future endoscopic surgery techniques for nasopharyngeal carcinoma have also been reviewed.

Key words: Nasopharyngeal neoplasms, Radiotherapy, Complications, Endoscopic surgical procedures, operative

中图分类号: 

  • R739.6
1 Chen MK , Lai JC , Chang CC , et al. Minimally invasive endoscopic nasopharyngectomy in the treatment of recurrent T1-2a nasopharyngeal carcinoma[J]. Laryngoscope, 2007, 117 (5): 894- 896.
doi: 10.1097/MLG.0b013e3180381644
2 黄波, 司勇锋. 鼻咽癌原发灶残留或复发的鼻内镜手术治疗[J]. 中国临床新医学, 2015, 8 (2): 174- 177.
doi: 10.3969/j.issn.1674-3806.2015.02.26
HUANG Bo , SI Yongfeng . The nasal endoscopic surgery in residual or recurrence of primary focal nasopharyngeal carcinoma[J]. Chinese Journal of New Clinical Medicine, 2015, 8 (2): 174- 177.
doi: 10.3969/j.issn.1674-3806.2015.02.26
3 Yoshizaki T , Wakisaka N , Murono S , et al. Endoscopic nasopharyngectomy for patients with recurrent nasopharyngeal carcinoma at the primary site[J]. Laryngoscope, 2005, 115 (8): 1517- 1519.
doi: 10.1097/01.MLG.0000165383.35100.17
4 陈明远, 郭翔, 文卫平, 等. 局限性残留、复发鼻咽癌的鼻内镜进路救援性外科治疗[J]. 癌症(英文版), 2007, 26 (7): 673- 678.
CHEN Mingyuan , GUO Xiang , WEN Weiping , et al. Salvage surgical operation via endoscopic transnasal approach for local persistent or recurrent nasopharyngeal carcinoma[J]. Chinese Journal of Cancer, 2007, 26 (7): 673- 678.
5 Chen MY , Wen WP , Guo X , et al. Endoscopic nasopharyngectomy for locally recurrent nasopharyngeal carcinoma[J]. The Laryngoscope, 2009, 119 (3): 516- 522.
doi: 10.1002/lary.20133
6 张维天, 郭金宝, 殷善开. 经鼻内镜挽救性手术治疗局部复发鼻咽癌[J]. 临床耳鼻咽喉头颈外科杂志, 2012, (12): 572- 576.
ZHANG Weitian , GUO Jinbao , YIN Shankai . Endonasal endoscopic salvage surgical treatment for local recurrent nasopharyngeal cancer[J]. Journal of Clinical Otorhinolaryngology, 2012, (12): 572- 576.
7 孙希才, 刘娟, 王欢, 等. 内镜下复发性鼻咽癌71例切除及预后分析[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50 (11): 890- 895.
doi: 10.3760/cma.j.issn.1673-0860.2015.11.003
SUN Xicai , LIU Juan , WANG Huan , et al. Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 71 patients and analysis of the prognostic factors[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2015, 50 (11): 890- 895.
doi: 10.3760/cma.j.issn.1673-0860.2015.11.003
8 陈卓, 邱前辉. 内镜手术治疗鼻咽癌残留或复发的临床疗效及生活质量分析[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50 (11): 896- 903.
doi: 10.3760/cma.j.issn.1673-0860.2015.11.004
CHEN Zhuo , QIU Qianhui . Analysis of clinical efficacy and the quality of life after endoscopic nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2015, 50 (11): 896- 903.
doi: 10.3760/cma.j.issn.1673-0860.2015.11.004
9 Huang Y , Qiu QH . Endoscopic surgery for early-stage nasopharyngeal carcinoma: a justified initial option[J]. Acta Otolaryngol, 2017, 137 (11): 1194- 1198.
doi: 10.1080/00016489.2017.1351041
10 粘家斌, 邱前辉. 鼻咽癌放疗后残留或复发不同rT分级的内镜挽救性手术特点分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30 (6): 459- 463.
doi: 10.13201/j.issn.1001-1781.2016.06.010
NIAN Jiabin , QIU Qianhui . Analysis of the characteristics of salvage endoscopic surgery for residual or recurrent nasopharyngeal carcinoma with different rT grading after radiotherapy[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30 (6): 459- 463.
doi: 10.13201/j.issn.1001-1781.2016.06.010
11 Wu Z , Su Y , Zeng RF , et al. Prognostic value of tumor volume for patients with nasopharyngeal carcinoma treated with concurrent chemotherapy and intensity-modulated radiotherapy[J]. J Cancer Res Clin Oncol, 2014, 140 (1): 69- 76.
doi: 10.1007/s00432-013-1542-x
12 邱前辉, 李娜, 张秋航, 等. 内镜手术治疗首诊局部晚期鼻咽癌的疗效分析[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52 (5): 365- 371.
doi: 10.3760/cma.j.issn.1673-0860.2017.05.009
QIU Qianhui , LI Na , ZHANG Qiuhang , et al. Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52 (5): 365- 371.
doi: 10.3760/cma.j.issn.1673-0860.2017.05.009
13 O'Dell K , Sinha U . Osteoradionecrosis[J]. Oral Maxillofac Surg Clin North Am, 2011, 23 (3): 455- 464.
doi: 10.1016/j.coms.2011.04.011
14 Lee CC , Ho CY . Post-treatment late complications of nasopharyngeal carcinoma[J]. Eur Arch Otorhinolaryngol, 2012, 269 (11): 2401- 2409.
doi: 10.1007/s00405-011-1922-2
15 Tuan JKL , Ha TC , Ong WS , et al. Late toxicities after conventional radiation therapy alone for nasopharyngeal carcinoma[J]. Radiotherapy and Oncology, 2012, 104 (3): 305- 311.
doi: 10.1016/j.radonc.2011.12.028
16 Chang KP , Tsang NM , Chen CY , et al. Endoscopic management of skull base osteoradionecrosis[J]. Laryngoscope, 2000, 110 (7): 1162- 1165.
doi: 10.1097/00005537-200007000-00018
17 黄晓明, 郑亿庆, 麦海强, 等. 鼻咽癌放射治疗后颅底骨坏死的诊断和治疗[J]. 中华耳鼻咽喉科杂志, 2004, 39 (9): 558- 561.
doi: 10.3760/j.issn:1673-0860.2004.09.013
HUANG Xiaoming , ZHENG Yiqing , MAI Haiqiang , et al. Diagnosis and treatment on osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma[J]. Chinese Journal of Otorhinolaryngology, 2004, 39 (9): 558- 561.
doi: 10.3760/j.issn:1673-0860.2004.09.013
18 陈卓, 邱前辉, 粘家斌, 等. 鼻咽癌放疗后大范围颅底骨坏死的内镜手术处理及颅底重建原则[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51 (12): 881- 886.
doi: 10.3760/cma.j.issn.1673-0860.2016.12.001
CHEN Zhuo , QIU Qianhui , NIAN Jiabin , et al. Endoscopic surgery and reconstruction for extensive osteoradionecrosis of skull base after radiotherapy for nasopharyngeal carcinoma[J]. Chinese JOurnal of Otorhinolaryngology Head and Neck Surgery, 2016, 51 (12): 881- 886.
doi: 10.3760/cma.j.issn.1673-0860.2016.12.001
19 张维天, 殷善开. 内镜下带血管蒂鼻中隔黏骨膜瓣修复颅底缺损[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46 (6): 463- 468.
doi: 10.3760/cma.j.issn.1673-0860.2011.06.006
ZHANG Weitian , YIN Shankai . An endoscopic approach to reconstruction of skull base defects using a vascular pedicled nasoseptal mucoperiosteal flap[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2011, 46 (6): 463- 468.
doi: 10.3760/cma.j.issn.1673-0860.2011.06.006
20 Kassam A , Snyderman CH , Mintz A , et al. Expanded endonasal approach: the rostrocaudal axis. Part Ⅰ. Crista galli to the sella turcica[J]. Neurosurg Focus, 2005, 19 (1): E3.
21 Snyderman CH , Kassam AB , Carrau R , et al. Endoscopic reconstruction of cranial base defects following endonasal skull base surgery[J]. Skull Base, 2007, 17 (1): 73- 78.
doi: 10.1055/s-2006-959337
[1] 卢朝阳, 翟兆雪, 王慧康, 邵丽婷, 张宇. 新冠肺炎治疗引发糖尿病酮症酸中毒合并鼻眶脑型毛霉菌病1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 90-94.
[2] 刘玉柱,苑铁君,李波. 会厌原发神经内分泌癌1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 97-100.
[3] 邱前辉,肖旭平,杨钦泰,叶菁,邓泽义,王德生,谭国林,蒋卫红,卢永田,唐隽,石照辉,邓晓聪,刘遗斌,王跃武,段传志,杜德坤,白小欣,陈文伙,莫立根,蔡楚伟,曾鹏,何旭英,杨一梅,赵洲洋,陈健龙,赵充,林志雄,李先明,李曙平,陈冬平,陈勇,黄莹,陈春燕,韩非,黄理金,瞿申红. 鼻咽癌治疗后并发颈动脉爆裂综合征的临床处理专家共识[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 1-18.
[4] 朱瑞楷,吴家荣,孙芳,谢楚波,邱前辉. 基于计算机断层扫描血管造影术评估鼻咽癌放疗后引起颈内动脉狭窄状况及其影响因素的研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 77-84.
[5] 马馨,董凌康,吴红敏,易红良,邹建银. 外展悬吊缝合技术在阻塞性睡眠呼吸暂停治疗中的改良及应用进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 81-88.
[6] 马莉,高瞻,李鹏起,倪前伟. 鼻眶筛并发颧骨骨折伴发症解剖研究现状[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 126-130.
[7] 李浩,杨丽媛,张守凯. 鼻窦药物缓释支架在难治性鼻窦炎中的短期临床观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 38-42.
[8] 鲁欢,何本超,廖红明. 儿童急性鼻窦炎合并眶眼蜂窝织炎并发颅内感染1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 46-50.
[9] 岳涛,庄大勇,周鹏,李小磊,徐婧,朱见,贺青卿. 达芬奇机器人甲状腺手术中气管损伤并发症4例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 46-50.
[10] 柴丽娜,雷春燕,高昇,张美霞. 孤立先天性视网膜动静脉畸形合并玻璃体出血和内界膜下出血1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 67-70.
[11] 栾国刚,谌金金,严涛. 两种自制简易装置取出玻璃体硅油的方法[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 80-84.
[12] 董曙光,郭凤飞,孟旭霞,颜世龙. 早期开展飞秒激光辅助白内障超声乳化手术前囊膜撕裂原因的回顾性分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 110-114.
[13] 陈世琴,卫平存,胡云龙,胡金旺. 糖皮质激素三种不同鼻用法对鼻内镜术后黏膜转归的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 195-201.
[14] 冯燚源,杨晶,杨洪斌. 220例颈深间隙感染临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 51-57.
[15] 李莹. 重视角膜屈光手术操作规范及并发症防治[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 1-6.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发