23例原发性咽旁间隙肿瘤的临床分析及手术方式探讨  

Clinical analysis and surgical treatment evaluation of 23 cases with primary parapharyngeal space tumors

作　　者：陈昊亮 孙国文[1] 唐恩溢[1] 胡勤刚[1] Chen Haoliang;Sun Guowen;Tang Enyi;Hu Qingang(Department of Oral and Maxillofacial Surgery,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院·南京市口腔医院口腔颌面外科,210008

出　　处：《中华口腔医学杂志》2019年第2期107-111,共5页Chinese Journal of Stomatology

摘　　要：目的探讨咽旁间隙肿瘤的手术治疗及计算机导航技术在近颅底高位咽旁间隙肿瘤手术中的应用价值,为临床提供参考。方法回顾性分析2011年11月至2017年12月于南京市口腔医院口腔颌面外科接受手术治疗的23例咽旁间隙肿瘤患者的临床资料。结果23例咽旁间隙肿瘤患者中,经颈侧入路7例,经腮腺入路4例,口内入路2例,经下颌骨劈开入路4例,联合入路6例。在7例高位咽旁间隙肿瘤中,3例采用术中导航,肿瘤平均最长径为5.7 cm,平均手术时间3.5 h;4例未采用术中导航,肿瘤平均最长径5.0 cm,平均手术时间4.0 h。术后病理显示,最常见的为多形性腺瘤(8例)和神经鞘瘤(5例)。术后随访时间为8~72个月,23例均未见复发、转移或死亡。结论手术切除是治疗咽旁间隙肿瘤的首选方法。对于近颅底的高位咽旁间隙肿瘤,计算机导航技术可以辅助精确判断肿瘤与颅底的位置关系,提高手术安全性,缩短手术时间,减少术后并发症,具有重要的临床应用价值。ObjectiveTo analyze the clinical characters and surgical treatment of primary parapharyngeal space (PPS) tumors.MethodsA total of 23 cases of primary PPS tumors which were treated from November 2011 to December 2017 were included for the retrospective analysis in this study.ResultsTwenty-three cases of patients with primary PPS tumors were analyzed in this study. Surgical approach was as follows: transcervial approach applied in 7 cases, transparotid approach in 4 cases, transoral approach in 2 cases, transmandibular approach in 4 cases, and the combined approaches on 6 cases. Besides, among 7 cases with upper PPS tumor, we applied the surgical navigation system in the surgery of 3 cases. The mean surgery duration of these cases, 3.5 h, was shorter than unused ones, while the mean maximum size (MMS) of tumors, 5.7 cm, was also larger. So far, 23 cases had no recurrence and metastasis. The most frequent histopathological type of all the cases was pleomorphic adenoma (8 cases), followed by Schwannoma (5 cases). With an 8-to-72-months follow up, 23 cases had no recurrence, metastasis or death.ConclusionsSurgical resection is preferred in the treatment of PPS tumors. In the upper PPS tumor cases, the surgical navigation system could reduce the operative duration significantly and is more suitable for larger tumors.

关 键 词：口腔肿瘤 外科手术 咽旁间隙肿瘤 计算机导航 

分 类 号：R739.8[医药卫生—肿瘤]