显微镜下切除颈部和咽旁神经源性肿瘤  

The resection of parapharyngeal space primary neuroplasm under surgical microscopy

作　　者：刘星伟[1] 樊韵平[2] 李春阳[3] 夏文彤[2] 

机构地区：[1]中山大学附属第五医院甲状腺血管外科,珠海519020 [2]中山大学附属第五医院耳鼻咽喉科,珠海519020 [3]中山大学附属第五医院口腔科,珠海519020

出　　处：《中华口腔医学研究杂志（电子版）》2012年第4期35-38,共4页Chinese Journal of Stomatological Research(Electronic Edition)

摘　　要：目的总结手术显微镜下切除儿童及青少年咽旁间隙神经源性肿瘤的经验。方法在手术显微镜下对6例原发于颈侧和咽旁间隙的神经源性肿瘤进行外科切除,患者均为儿童及青春期少年,其中神经纤维瘤2例,神经鞘膜瘤3例,副神经节瘤1例。神经来源包括迷走神经、颈交感神经丛、颈丛神经、舌下神经及颈动脉体。结果 6例肿瘤中5例完全切除,1例近全切除。术后并发症包括一过性的Horner氏征1例,暂时性呛咳1例,暂时性伸舌偏斜1例,暂时性手臂握持无力1例,随访期内均完全恢复。持久性迷走神经切除1例。结论在显微镜下切除神经源性肿瘤有一定优点,主要有尖源明亮、组织辨别度高、神经损伤小、重要结构观察清晰的特点,易于同期做神经修复等。Objective To evaluate the experience of the resection of parapharyngeal or cervical primary neurogenic neoplasm in 6 children or adolescence. Methods The 6 cases of primary neurogenic tumor in parapharyngeal space and neck were operated under surgical microscope, 2 out of 6 are neurofibromas, 3 out of 6 neurolemmas, 1 was paraganglioma; the involved nerve include vagal, cervical sympathetic, cervical plexiform, hypoglossal, and carotid body. Results Five out of the six masses were resected totally, one of them was subtotal resected. In one case the vagus was sacrificed. The complications included transient Homer＇s syndrome （1 case）, transient choke and dysphagia （1 case）, 1 case had transient weak grip of ipsilateral hand, transient tongue stick skew. All the dysfunction of related nerves had been recovered during the follow up. Conclusions There are several advantages to removal cervical neurogenic tumor dissected under microscope through thanscervical approach, excellent illumination, fine tissue contrast, much little injury for associated nerves, and easy for simultaneous end to end anastomosis of injured nerves with important function.

关 键 词：肿瘤 咽旁间隙 神经源性肿瘤 儿童 显微镜 

分 类 号：R739.6[医药卫生—肿瘤]