咽旁隙肿瘤的手术治疗  

Surgical treatment of parapharyngeal space tumors

作　　者：亓卫东 孙广滨 陈仲春 曹轶倓 袁芳 高海河 张国梁 严文洪 

机构地区：[1]复旦大学附属华山医院耳鼻咽喉头颈外科,上海200040

出　　处：《中国耳鼻咽喉颅底外科杂志》2017年第5期444-448,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨咽旁隙肿瘤的诊断及手术入路的选择。方法回顾性分析经手术诊断及治疗的52例咽旁隙肿瘤的临床资料,包括症状、体征、手术入路及术后病理结果。结果 52例患者中23例(44.2%)经颈侧入路,14例(27%)经腮腺颈侧(腮颈)入路,10例(19.2%)为颈侧下颌骨入路,5例(9.6%)经口内入路。术后病理良性占80.8%,恶性19.2%。唾液腺及神经源性肿瘤分别占总数的46.2%和28.8%。52例患者中48例行Ⅰ期手术切除,术后恶性肿瘤复发率30%(3/10),良性肿瘤复发率7.1%(3/42)。结论术前运用影像学及组织病理学手段判断肿瘤性质及与周围重要结构的关系对于制定和完善手术计划至关重要,选择合适的手术入路有助于术中充分暴露肿瘤,提高手术安全性和减少术后并发症。Objective To explore the diagnosis and the selection of surgical approaches for parapharyngeal space tumors.Methods Clinical data of 52 patients with parapharyngeal space tumors surgically treated were analyzed retrospectively.The data included clinical symptoms,signs,surgical approaches and postoperative pathological results.Results The adopted surgical approaches were transcervical（23/52,44.2%）,transcervical-parotid（14/52,27%）,transmandibular（10/52,19.2%） and intraoral（5/52,9.6%）.Postoperative pathology revealed that benign tumor held a majority（80.8%） and malignancy accounted for 19.2%.As for the primary lesions,slavery gland tumors and neurogenic tumors accounted for 46.2% and 28.8% of the total respectively.Complete resection of the tumors was achieved in 48 cases with recurrence rate of 30%（3/10） in patients with malignant tumors and 7.1%（3/42） in benign ones.Conclusion It is important to prejudge the properties and anatomical relationships with vital structures of the parapharyngeal space tumors through CT,MRI and pathological examination.Selection of appropriate surgical approach can benefit full exposure of tumor,improvement of surgical safety,and decrease of postoperative complications.

关 键 词：咽旁隙肿瘤 手术入路 治疗 

分 类 号：R739.63[医药卫生—肿瘤]