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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Cranial nerve outcomes in regionally recurrent head & neck melanoma after sentinel lymph node biopsy
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Cranial nerve outcomes in regionally recurrent head & neck melanoma after sentinel lymph node biopsy

机译：在Sentinel淋巴结活检后区域复发头和颈黑色素瘤中的颅神经结果

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Objective Characterize long‐term cranial nerve (CN) outcomes following sentinel lymph node biopsy (SLNB) based management for head and neck cutaneous melanoma (HNCM). Methods Longitudinal review of HNCM patients undergoing SLNB from 1997–2007. Results Three hundred fifty‐six patients were identified, with mean age 53.5?±?19.0?years, mean Breslow depth 2.52?±?1.87?mm, and 4.9?years median follow‐up. One hundred five (29.4%) patients had SLNB mapping to the parotid basin. Eighteen patients had positive parotid SLNs and underwent immediate parotidectomy / immediate completion lymph node dissection (iCLND), with six possessing positive parotid non‐sentinel lymph nodes (NSLNs). Fifty‐two of 356 (14.6%) patients developed delayed regional recurrences, including 20 total intraparotid recurrences: five following false negative (FN) parotid SLNB, three following prior immediate superficial parotidectomy, two following iCLND without parotidectomy, and the remaining 12 parotid recurrences had negative extraparotid SLNBs. Parotid recurrences were multiple (4.9 mean recurrent nodes) and advanced (n = 4 extracapsular extension), and all required salvage dissection including parotidectomy. Immediate parotidectomy/iCLND led to no permanent CN injuries. Delayed regional HNCM macrometastasis precipitated 16 total permanent CN injuries in 13 patients: 10 CN VII, five CN XI, and one CN XII deficits. Fifty percent (n = 10) of parotid recurrences caused ≥1 permanent CN deficits. Conclusions Regional HNCM macrometastases and salvage dissection confer marked CN injury risk, whereas early surgical intervention via SLNB ± iCLND ± immediate parotidectomy yielded no CN injuries. Further, superficial parotidectomy performed in parotid‐mapping HNCM does not obviate delayed intraparotid recurrences, which increase risk of CN VII injury. Despite lack of a published disease‐specific survival advantage in melanoma, early disease control in cervical and parotid basins is paramount to minimize CN complications. Level of Evidence 4 (retrospective case series) Laryngoscope , 130:1707–1714, 2020
机译：目的表征在Sentinel淋巴结活检（SLNB）的头部和颈部皮肤黑色素瘤（HNCM）中的长期颅神经（CN）结果。方法1997 - 2007年患有SLNB患者的HNCM患者纵向综述。结果鉴定了三百五十六名患者，平均53.5岁？±19.0？年，意味着Brieslow深度2.52？±1.87？mm和4.9？岁月的后续行动。一百五（29.4％）患者对腮腺盆地进行了SLNB。十八名患者具有阳性腮腺SLNS并进行立即静态切感术/即时完全淋巴结解剖（ICLND），具有六个具有阳性腮腺非哨淋巴结（NSLNS）。五十二356（14.6％）患者发展延迟区域复发，包括20次总intraparotid复发：5以下假阴性（FN）腮腺SLNB，以下三个前立即浅表腮腺，以下两个iCLND无腮腺，其余12次腮腺复发有阴性外来的slnbs。腮腺炎复发是多个（4.9个平均复发节点）和先进的（n = 4个骨折延伸），并且所有必需的挽救裂解术，包括腮腺切除术。立即腮腺切除术/ ICLND导致任何永久性CN损伤。延迟区域HNCM Macrometasis沉淀了13名患者的16个全永久性CN损伤：10 CN VII，5 CN XI和一个CN XII缺陷。腮腺炎的五十百分之五十（n = 10）导致≥1永久性CN缺陷。结论区域HNCM Macrometers和救生解剖赋予Cn损伤风险，而通过SLNB±ICLND±即时腮腺切除术的早期手术干预产生NO CN损伤。此外，浅腮腺腮腺映射HNCM执行并不排除延迟intraparotid复发，CN VII损伤其增加风险。尽管黑色素瘤中缺乏出版的疾病特异性生存优势，但宫颈和腮腺盆地的早期疾病控制是最重要的，以尽量减少CN并发症。证据级别4（回顾案例系列）喉镜，130：1707-1714,2020

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