34例颞下窝占位性病变的诊断与治疗  

DIAGNOSIS AND TREATMENT OF THE SWELLINGS OF THE INFRATEMPORAL FOSSA (34 CASES RE-PORTED)

作　　者：廖海星[1] 廖文满[1] 陶远孝[1] 陈立[1] 武要洪[2] 

机构地区：[1]四川省肿瘤医院头颈外科,成都610041 [2]云南省肿瘤医院头颈外科

出　　处：《中国癌症杂志》1998年第4期286-288,共3页China Oncology

摘　　要：目的 探讨提高颞下窝占位性病变的诊治水平.方法 对34例颞下窝占位病变进行回顾性统计分析.结果 男性23例,女性11例.年龄为5～68岁,平均53岁.占位性病变以恶性肿瘤为主占65%,良性肿瘤及非肿瘤各占26%和9%;继发者76%,原发者21%,肿瘤远处转移至此窝者3%;颅外者91%,与颅内沟通者9%,以颌面部肿块、面痛与张口受限为主要临床表现,其中面痛及张口受限与恶性肿瘤占位呈相关关系(前者P<0.005,后者P<0.05).70%病例通过并非以发现颞下窝占位为目的的颅颌面CT或MRI检查获得诊断;仅9%以发现该窝占位病变为目的的CT检查而获诊断;6%病例出现CT假阴性;15%术前漏诊.CT或MRI正良恶性确诊率为87.5%.恶性肿瘤组二年生存率为52%.结论 掌握该窝占位病变各种临床表现及检查手段,可提高诊断水平,减少无计划性手术,可避免复发;并提高恶性肿瘤的二年生存率.PURPOSE To raise the level of the diagnosis and treatment of the swellings of the infratemporal fossa. METHODS Retrospective case study. RESULTS 23 cases are male, 11 female, aged from 5 to 68 years. 65% cases are malignant. 26% benign and 9% non-neoplastic. 76% cases are secondary, 21% primary and 3% metastatic; 91% are extracranial, and 9% intracranial. The masses of facial-maxillary region, facial pain and tris-mus are the main clinical presentations, with facial pain and trismus having a relation to malignancies, P<0. 005 and P<0. 05, respectively. 70% cases were diagnosed by routine head CT or MRI; only 9% diagnosed with the intention of defining the swellings: 6% had false negative CT results, and 15% failed to be diagnosed before operation. 2 year survival rate is 52% in the malignancy group. CONCLUSION We emphazise the accuracy of the pre-operation diagnosis and the accessibility of the operative plan. The 2 year survival rate can be improved while the unplanned surgery of the infratemporal fossa further decreased.

关 键 词：颞下窝 肿瘤 诊断 外科学 手术 

分 类 号：R739.41[医药卫生—肿瘤]