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Chirurgische Zugangswege zum Mesopharynx

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Zusammenfassung

Ausgedehnte Tumoren des hinteren Mundraumes und des Oropharynx sowie des parapharyngealen Raumes sind nicht immer einer transoralen Laserresektion zugänglich. Insbesondere Tumoren des Zungengrundes, der Vallecula sowie von den Speicheldrüsen ausgehende Tumoren des Parapharyngealraumes erfordern eine übersichtliche chirurgische Exposition aus 3 Gründen: Nur bei guter Übersicht ist eine Resektion im Gesunden (R0) möglich. Enstehende Operationsdefekte können mit lokoregionären oder mikrovaskulären Transplantaten einzeitig verschlossen werden. Arrosionsblutungen im Heilungsverlauf werden so weitestgehend vermieden. Der Artikel gibt eine Übersicht über die derzeit üblichen chirurgischen Zugangswege zum Mesopharynx und v. a. über die mediane Mandibulotomie einschließlich der Plastiken zur Defektdeckung.

Abstract

Because of their localization and their extent, tumours of the deep oral cavity, the oropharynx and the parapharyngeal space are rarely accessible for CO2 laser dissection. Especially malignant tumours of the base of the tongue and the vallecula as well as salivary gland-related tumours of the parapharyngeal space need wide conventional surgical exposure to allow: resection respecting tumor margins (R0); oropharyngeal and tongue reconstruction using local and microvascular grafts; prevention of mass-bleeding caused by infectious destruction of large blood vessels. This article reviews the different surgical approaches to oropharyngeal tumours with special reference to “mandibular swing” procedures. Moreover, different graft techniques are critically assessed.

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Authors and Affiliations

  1. Klinikum Ernst von Bergmann, Potsdam

    M. Jungehülsing

  2. Klinik und Poliklinik für HNO-Heilkunde, Universität zu Köln, Köln

    O. Guntinas-Lichius, J. P. Klussmann & U. Schröder

  3. HNO-Heilkunde, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 , Potsdam

    M. Jungehülsing

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  1. M. Jungehülsing
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  2. O. Guntinas-Lichius
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  3. J. P. Klussmann
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  4. U. Schröder
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Correspondence to M. Jungehülsing.

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Herrn Prof. Dr. med. E. Stennert zum 65. Geburtstag gewidmet

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Jungehülsing, M., Guntinas-Lichius, O., Klussmann, J.P. et al. Chirurgische Zugangswege zum Mesopharynx. HNO 51, 931–949 (2003). https://doi.org/10.1007/s00106-003-0966-z

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