内镜经口入路腮腺深叶多形性腺瘤切除术  

Resection of deep-lobe parotid pleomorphic adenoma via a pure endoscopic transoral approach

作　　者：吕海丽[1] 张秋航[1] 严波[1] 王振霖[1] 杨晓彤[1] LYU Hai-li;ZHANG Qiu-hang;YAN Bo;WANG Zhen-Lin;YANG Xiao-tong(Department of Otolaryngology-Head and Neck Surgery, Skull Base Surgery Center, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院耳鼻咽喉颅底外科中心,北京100053

出　　处：《中国耳鼻咽喉颅底外科杂志》2018年第2期114-118,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨内镜经口入路切除腮腺深叶多形性腺瘤的可行性及疗效。方法采用单纯内镜经口入路切除腮腺深叶多形性腺瘤6例,男4例,女2例,年龄18~56岁,平均年龄36岁。其中2例为无意中体检发现咽侧壁膨隆,1例为头痛,3例为咽喉异物感半年。结果 6例均完整切除,且无面瘫、声嘶、吞咽困难、伸舌偏斜等颅神经受损症状,仅有1例术后出现腮区肿痛,加压抗感染后改善。术后随访12~40个月,平均24个月,其中1例术后2年复发,病理为腮腺混合瘤恶变。结论内镜经口入路可以彻底切除腮腺深叶多形性腺瘤,是安全、微创的能保留面神经功能的手术入路,但对腮腺恶性肿瘤仍建议开放式入路。Objective To explore the feasibility and curative effect of resection of deep-lobe parotid pleomorphic adenoma via a pure endoscopic transoral approach. Methods Six patients with pleomorphic adenoma of deep-lobe parotid gland（4 males and 2 females,ranging in age from 18 to 56 years old with an average of 36） received direct surgical resection of tumor via endoscopic transoral approach. As for the symptoms and signs,lateral pharyngeal wall bulging was detected in 2 patients in health examinations,one patient complained of headache,and the other 3 complained of throat indisposition. Results Complete removal of the tumor was achieved in all the 6 cases,and no complications such as facial paralysis,hoarseness and dysphagia occurred. Postoperative swelling and pain in the parotid area occurred in one patient and got improved through anti-infective therapy combined with pressure dressing. All patients had been followed up for 12 months to 40 months with an average of 24. Tumor recurrence occurred in one patient due to malignant transformation 2 years after operation. Conclusion Pleomorphic adenoma of deep-lobe parotid gland can be resected completely via endoscopic transoral approach which is safe, minimally invasive, and capable of reserving facial nerve function.Nonetheless,open surgical approach is recommended for the resection of malignant parotid tumors.

关 键 词：内镜经口入路 多形性腺瘤 腮腺深叶 

分 类 号：R782.05[医药卫生—口腔医学]