41例咽旁间隙肿瘤患者的诊疗分析  

Diagnosis and surgical treatment of parapharyngeal space tumor in 41 cases

作　　者：何龙 谢景华 高雄辉 杨雅琳 He Long;Xie Jinghua;Gao Xionghui;Yang Yalin(Department of Otorhinolaryngology,Head and Neck Surgery,Guangzhou First People’s Hospital,Second Affiliated Hospital of South China University of Technology,Guangzhou,Guangdong 510180,China)

机构地区：[1]广州市第一人民医院耳鼻咽喉头颈外科,华南理工大学附属第二医院耳鼻咽喉头颈外科,广州510180

出　　处：《中华生物医学工程杂志》2019年第5期594-598,共5页Chinese Journal of Biomedical Engineering

摘　　要：目的探讨咽旁间隙肿瘤的临床特点和外科治疗。方法回顾性分析广州市第一医院耳鼻咽喉头颈外科2001年7月至2019年1月期间收治的41例咽旁间隙肿瘤患者的临床资料,总结分析其临床表现、术前影像学诊断、病理类型、手术径路选择、术后并发症及预后。结果41例咽旁间隙肿瘤中良性37例,恶性4例,临床表现多为患侧上颈部无痛性肿物或口咽侧壁隆起并伴有不同程度的吞咽或构音功能障碍。术后病理诊断神经源性肿瘤22例(54%),涎腺来源肿瘤13例(32%)。术前影像学诊断与术后病理诊断符合率为75.6%(31/41),其中MR、CT或B超的术前诊断符合率分别为86.2%(25/29)、53.8%(7/13)或50%(1/2)。在手术方面,经口径路22例(54%),颈侧径路14例(34%),侧颅底径路4例(10%),颈腮径路1例(2%),围术期并发症4例,均发生在神经源性肿瘤患者。结论咽旁间隙肿瘤周围解剖结构复杂,病理类型多样,颈部增强MR扫描应做为术前首选的影像学检查,手术切除是主要的治疗方法,但应根据肿瘤病理类型、大小及周围结构关系决定手术方式。对于神经源性肿瘤,手术并发症相对较多,术前应与患者充分沟通手术风险。Objective To investigate the clinical features and surgical treatment of parapharyngeal space tumor.Methods The clinical data of 41 patients with parapharyngeal space tumor admitted to the Department of Otolaryngology,Head and Neck Surgery,Guangzhou First People’s Hospital between July 2001 and January 2019,were retrospectively analyzed.The clinical manifestations,preoperative imaging diagnosis,pathological type,surgical approaches,postoperative complications and prognosis were summarized and analyzed.Results Of the 41 cases of parapharyngeal space tumor,37 were benign and 4 were malignant.The clinical manifestations were mostly painless masses at the upper neck of the affected side or swelling of the lateral oropharyngeal wall with varying degrees of dysphagia or dysarthria.According to the postoperative pathology,there were 22 cases of neurogenic tumor(54%)and 13 cases of salivary gland tumor(32%).The coincidence rate of preoperative imaging diagnosis and postoperative pathological diagnosis was 75.6%(31/41).The coincidence rates of preoperative diagnosis of MR,CT or B-ultrasound were 86.2%(25/29),53.8%(7/13)and 50%(1/2),respectively.The surgical approaches included 22 cases(54%)of trans-oral approach,14(34%)of lateral cervical approach,4(10%)of lateral cranial base approach,and 1(2%)of cervical-parotid approach.Perioperative complications occurred in 4 patients with neurogenic tumor.Conclusion The adjacent anatomical structure of parapharyngeal space tumor is complicated and the pathological types are various.Enhanced MR scan of the neck should be the primary option for preoperative imaging examination.Surgical resection is the major treatment option,which should be based on the tumor pathological type,size and adjacent structure.As surgical complications occur frequently in patients with neurogenic tumor,the risk of surgery should be fully communicated to patients before the operation.

关 键 词：耳鼻咽喉肿瘤 诊断 外科手术 

分 类 号：R73[医药卫生—肿瘤]