咽旁间隙良性肿瘤84例临床分析  

Clinical analysis of 84 cases of parapharyngeal space benign tumors

作　　者：丁永清[1] 周梁[1] 陈琦[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2014年第5期291-295,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨咽旁间隙良性肿瘤的临床特征、诊断方法、病理类型、手术径路选择及治疗效果等。方法回顾分析本科2008年1月-2014年1月期间经手术治疗的84例咽旁间隙良性肿瘤患者的临床资料。结果男性35例、女性49例;平均年龄45.39岁。均无特异性症状,多因体检或偶然发现而就诊。主要体征为咽侧壁膨隆、软腭隆起和（或）扁桃体移位44例、颈部肿物21例,其余19例未发现阳性体征,仅影像学检查显示咽旁间隙占位。术后组织病理学类型多样,主要为多形性腺瘤和神经鞘瘤。经单纯颈侧切口入路切除肿瘤77例,经口径路2例,经颈侧-腮腺入路3例,经颈侧-下颌骨裂开术2例。经一次手术完整切除83例。随访3-73个月,平均36个月,复发1例。结论咽旁间隙位置深在、隐蔽,解剖毗邻复杂,发生于该间隙的肿瘤多无特异性症状,病理类型多样。CT和磁共振成像是诊断咽旁间隙肿瘤的重要工具。咽旁间隙良性肿瘤以单纯颈侧切口径路切除为主,一次性完整切除率高,预后良好,复发率较低。Objective To investigate the clinical characteristics , diagnostic method , pathological type , surgical approaches and the therapeutic effect of parapharyngeal space benign tumors .Methods A retrospective review was carried out on 84 patients with benign tumors in parapharyngeal space treated from January 2008 to January 2014.Results Of the 84 patients enrolled, 35 were male and 49 were female, with a median age of 45 years.The symptoms were not characteristic and the main clinical manifestation comprised of lateral pharyngeal wall swelling in 44 patients, neck mass in 21 cases but there was no any clinical symptom and sign in the remaining 19 patients.The post-operative histopathology varied and that pleomorphic adenoma and schwannoma were the main types .The simple transcervical approach alone was performed in 77 patients,the transoral approach in 2 patients, and the transcervical plus transparotid approach was applied in 3 patients.The transcervical in combination with the transmandibular approach was used in 2 patients.Eighty-three patients had been cured with one operation .The median follow-up period was 36 months and local recurrence was observed in one patient .The post-operative complications included hemorrhage in 2 cases, surgical site infection in 2 patients, vocal cord paralysis in one patient and facial paralysis in one patient .Conclusions The parapharyngeal space is a complex anatomic region .The clinical manifestations of parapharyngeal space neoplasms were nonspecific and the pathological types of which were diversified .CT and magnetic resonance imaging were essential for the diagnosis of parapharyngeal space neoplasms .Most of the parapharyngeal space tumors are benign lesions .The majority of tumors could be excised safely and completely by using the transcervical approach .The benign lesions have good therapeutic effect, with favourable prognosis.

关 键 词：咽旁间隙 良性肿瘤 诊断 手术方式 并发症 

分 类 号：R739.63[医药卫生—肿瘤]