PDF(Pubmed)
Abstract：
Management of advanced gingivo-buccal complex cancers involving the masticatory space (T4b) is often managed by compartment resection. The oncological safety of the procedure is now clearly established. Based on the origin and epicenter of the tumor there are two classes of compartmental resection. Those tumors arising from the tuberosity of the maxilla and/or upper gingival sulcus region; the resection involves the tumor, posterior maxilla, and the ipsilateral infratemporal fossa. These tumors can be resected by mandibulotomy approach, preserving the mandible. This constitutes class-1 infratemporal fossa resection. The class-2 infratemporal fossa resection is applied for those tumors arising from the retromolar trigone and/or lower gingivo-buccal sulcus region. In this class, the mandible and often the overlying cheek skin needs to be sacrificed, in addition to the contents of the infratemporal fossa and the posterior maxilla. Both the classes of resections are carried out in an orderly fashion following well-defined steps. These sequential steps maximize the exposure of inaccessible structures, enables protection of critical structures as well as minimizes blood loss. This manuscript describes the surgical steps for the two classes of compartmental resection of the infratemporal fossa for advanced gingivo-buccal complex cancers involving the masticatory space.
摘要：
涉及咀嚼空间（T4b）的晚期牙龈-口腔复合体癌的管理通常通过隔室切除术来管理。该程序的肿瘤安全性现已明确。根据肿瘤的起源和中心，有两类房室切除。上颌骨和/或上龈沟区域结节引起的肿瘤；切除涉及肿瘤，上颌骨后部,和同侧颞下窝.这些肿瘤可以通过下颌骨切开术切除，保留下颌骨。这构成1类颞下窝切除术。2类颞下窝切除术适用于那些由后磨牙三角区和/或下牙龈-颊沟区域引起的肿瘤。在这个课上,下颌骨和经常覆盖的脸颊皮肤需要牺牲，除了颞下窝和后上颌骨的内容。这两类切除都是按照明确定义的步骤以有序的方式进行的。这些连续的步骤最大限度地暴露于难以接近的结构，使关键结构的保护以及最大限度地减少失血。该手稿描述了颞下窝的两类隔室切除术的手术步骤，用于治疗涉及咀嚼空间的晚期牙龈-颊复杂癌症。
