经颈外内镜辅助下茎突截短术48例的临床分析  

Treatment of styloid process truncation assisted by endoscope through the marginal mandibular branches in 48 patients

作　　者：郑鹏凌 耿少筠 卢俊 龚晓华 彭俊 廖玲凤 汪奕 ZHENG Pengling;GENG Shaojun;LU Jun;GONG Xiaohua;PENG Jun;LIAO Lingfeng;WANG Yi(Department of Otolaryngology,Yongzhou Central Hospital,Yongzhou 425000,China)

机构地区：[1]永州市中心医院耳鼻咽喉科,湖南永州425000

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第5期581-583,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探寻一种经颈外下颌下缘内镜辅助下茎突截短术,降低手术难度及减少并发症,便于临床推广应用。方法收集经颈外下颌下缘内镜辅助下行茎突截短术患者48例,经颈外下颌角下方切皮,切开颈阔肌及下颌骨下方筋膜,直接进入咽旁间隙,手指探查寻找过长的茎突及尖端,钝性分离茎突,内镜辅助下截短茎突。观察手术切口大小、术野显露程度、术中寻找茎突及分离情况、出血情况、手术时间、术后并发症发生情况。结果 48例患者手术中均可很好地暴露茎突,容易分离,所有手术出血<10 ml,手术时间≤20 min,切口均I期愈合,术后切口隐蔽,无出血、感染等并发症。1例术后出现下唇轻度外翻,考虑面神经下颌缘支受损,加用地塞米松治疗,1周后面神经功能恢复。术后1个月复查,所有患者对面部瘢痕及治疗效果满意。结论经颈外内镜辅助下行茎突截短术手术时间短、出血少、并发症少,有良好的临床应用价值,值得临床推广。Objective To explore a new method of microendoscopic resection of styloid process, it can reduce the operation difficulty and complication, which is convenient for clinical application.Methods 48 patients underwent endoscopic styloid process truncation through the lateral mandibular branche, which was incised the platysma muscle and the submandibular.Fascia directly into the parapharyngeal space, blunt dissection of styloid process and endoscope-assisted truncation of styloid process were performed to observe the size of incision, exposure of surgical field, searching styloid process during operation, separation, bleeding, operation time and postoperative complications.Results The styloid process was easily separated and exposed in all 48 patients. The bleeding was less than 10 ml. The incision was treated in 20 minutes.All the incisions were healed in stage I. The incision was hidden,which was no bleeding, infection or other postoperative complications.One case presented mild lower lip eversion after surgery,which might be the damaged facial nerve in the marginal mandibular branch.After dexamethasone was added for treatment, and the nerve function was recovered after 1 week. One month post-the operation, all the patients were satisfied with the facial scar and treatment effect.Conclusion The resection of styloid process assisted by external cervical endoscope has short operation time, less bleeding and less complications, and has good clinical application value,which is worth popularizing.

关 键 词：茎突过长 颈外径路 内镜 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]