原发性咽旁间隙肿瘤治疗的回顾性分析  

Retrospective analysis of primary parapharyngeal space tumors

作　　者：赵建东[1] 文艺 纵亮[1] 陈立伟[1] 刘明波[1] 黄德亮[1] 王嘉陵[1] 武文明[1] 吕萍[2] 冯勃[1] ZHAO Jiandong;WEN Yi;ZONG Liang;CHEN Liwei;LIU Mingbo;HUANG Deliang;WANG Jialing;WU Wenming;LV Ping;FENG Bo(College of Otorhinolaryngology Head and Neck Surgery,PLA General Hospital,Chinese PLA Medical School,National Clinical Research Center for Otolaryngologic Diseases,State Key Lab of Hearing Science,Ministry of Education,Beijing Key Lab of Hearing Impairment Prevention and Treatment,National Engineering Laboratory for Medical Big Application Technology,Beijing,100853,China;Department of Otolaryngology Head and Neck Surgery,Chuanbei Medical College)

机构地区：[1]解放军总医院耳鼻咽喉头颈外科,医学部国家耳鼻咽喉疾病临床医学中心,聋病教育部重点实验室聋病防治北京市重点实验室,解放军总医院医疗大数据应用技术国家工程实验室,北京100853 [2]川北医学院附属医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第8期743-747,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家863计划(No:2015AA8092017D);解放军总医院医疗大数据研发项目(No:2017MBD-018)。

摘　　要：目的:探讨原发性咽旁间隙肿瘤的临床特点及外科治疗方法。方法:回顾性分析214例原发性咽旁间隙肿瘤患者的临床资料,对其临床表现、影像学评估、病理类型、手术径路选择及并发症发生等进行分析。结果:214例咽旁间隙肿瘤患者中,良性135例(63.1%),恶性79例(36.9%);良性肿瘤发病无性别差异,男∶女为1∶1,恶性肿瘤发病率男性高于女性,男∶女为3.3∶1,无论良恶性肿瘤,其高发年龄段为40~59岁。咽旁间隙肿瘤中2/3的患者有不同程度的周围结构侵犯,累及颅底者最为常见,为76例(35.5%),其次为血管和神经,分别为24例(11.2%)和16例(7.5%)。65例(31.4%)术后发生并发症,常见并发症为第X脑神经麻痹引起的声嘶。结论:咽旁间隙肿瘤病理类型多样,手术是治疗咽旁间隙肿瘤的主要手段,应根据影像学检查、病变部位、性质等综合考虑,选择合适的手术方案,术前应充分告知并发症的风险,取得患者的配合。Objective:To explore the clinical feature and surgical treatment of patients with parapharyngeal space tumors.Method:A retrospective review of 214 cases with parapharygeal space tumors treated.The data on clinical manifestations,imaging examinations,pathological types,surgical approach,and postoperative complications were reviewed.Result:Of the 214 cases,the tumor was benign in nature in 135 cases(63.1%)and malignant in 79 cases(36.9%).There was no gender difference in the incidence of benign tumors,and the ratio of male to female was 1:1.The incidence of malignant tumors was higher in males than in females,and the ratio was 3.3:1.Regardless of benign and malignant tumors,the high incidence age is 40-59.Two-thirds of cases of parapharyngeal space tumors had different degrees of peripheral structural invasion.The most common cases involving the skull base were 76 cases(35.5%),followed by blood vessels and nerves,24 cases(11.2%)and 16 cases(7.5%),respectively.Complications occurred in 65 patients(31.4%),the most common complications were hoarseness caused by X-cranial nerve palsy.Conclusion:There are various pathological types of parapharyngeal space tumors,and surgery is the first choice for parapharyngeal space tumors.The surgical plan should be made according to the imaging examinations,lesions,and the pathology et al.The risk of complications should be fully informed before the operation,and the cooperation of the patients should be obtained.

关 键 词：咽旁间隙肿瘤 临床特点 外科手术 

分 类 号：R739.63[医药卫生—肿瘤]