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Korean Journal of Otorhinolaryngology-Head and Neck Surgery > Volume 34(1); 1991 > Article
Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1991;34(1): 122-135.
The clinical analysis of surgical management of aquamous cell carcinoma in floor of mouth.
Jae Wook Eom, Yo Han Chai, Hyun Soo Kim, Chun Keun Park
구강저 편평상피암의 수술적 치료에 대한 임상적 고찰
엄재욱 · 채요한 · 김현수 · 박춘근
인제대학교 의과대학 부산백병원 이비인후과학교실
ABSTRACT

The authors report 18 cases of the squamous cell carcinoma in floor of mouth with preoperative and postoperative findings and surgical methods who had been treated in Pusan Paik Hospital from Jan. 1986 to Sept. 1988. The results were as follows; 1) In the sex distribution, 16 cases(88.9%) were male and 2 cases(11.1%) were female. So the male was predominant. And the age distribution was from 45 to 72 years old and the mean age was 58 years old. 2) The distributions of involved sites were as follows; There were 5 case(27.7%) of midline, 3 cases(16.7%) of anterior part, 7 cases(38.9%) of posterior part and 3 cases(16.7%) of combined midline and anterior part. 3) The distributions of clinical stages were 2 cases(11.1%) of stage I, 3 cases(16.7%) of II, 7 cases(38.9%) of III and 6 cases(33.3%) of IV. 4) The methods of treatment were as follows; There were 1 case(5.6%) of operation only, 3 cases(16.7%) of operation with preoperative chemotherapy, 6 cases(33.3%) of operation with preoperative chemotherapy and postoperative radiotherapy. 5) In methods of the skin incision, 4 cases of lip splitting with chin splitting and 13 cases of lip splitting with chin sparing incisions were performed, and 1 case(5.6%) was not performed. 6) In the managaments of the mandible, there were 9 cases(50.0%) of mandibulotomy, 2 cases(11.1%) of marginal mandibulectomy, 4 cases(22.2%) of segmental mandibulectomy and 2 cases(11.1%) of hemimandibulectomy, and 1 case(5.5%) was not managed the mandible. 7) The neck dissections were as follows ; There were 5 cases(27.8%) of ipsilateral supraomohyoid neck dissection, 3 cases(16.7%) of lipsilateral radical neck dissection, 4 cases(22.2%) of ipsilateral radical neck dissection and contralateral supraomohyoid neck dissection and 2 cases (11.1%) of bilateral radical neck dissection, and 4 cases were not performed. 8) In the reconstructions, we used 2 cases of sternocleidomastoid myocutaneous flaps, 6 cases of pectoralis major myocutaneous flaps, 1 case of pectoralis major myocutaneous flap with Kirschner wire, 1 case of nape of neck flap, 3 cases of tonge flaps, 3 cases of skin gragfs and 2 cases of primary suture. 9) In the blood losses during operation, 3 cases(16.7%) of below 2,000cc 3 cases(16.7%) of 200-400cc, 8 cases(44.5%) of 400-800cc, 2 cases(11.1%) of 800-1,000cc, 1 case(5.6%) of 1,000-1,200cc and 1 case(5.6%) of 1,200-1,500cc were noted. 10) In the postoperative complications, there were 4 cases(17.3%) of orocutaneous fistula, 5 cases(21.7%) of disarticulation, 2 cases(8.8%) of facial palsy, 1 case(4.3%) of swallowing difficulty, 2 cases(8.8%) of skin contracture, 5 cases(21.7%) of malocclusion, 2 cases(8.8%) of facial edema, 1 case(4.3%) of headache and 1 case(4.3%) of limitation of month opening.

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