内镜辅助经口低温等离子手术治疗茎突综合征  

Endoscopic-assisted Transoral Temperature-controlled Radiofrequency Surgery for Styloid Process Syndrome

作　　者：李涛[1] 邱梓瀚 孙健斌 王丽[1] 闫燕[1] 孟超[1] 王晓晓[1,2] 刘仲奇[1] Li Tao;Qiu Zihan;Sun Jianbin;Lin Zhongqi(Department of Otolaryngology, Peking University Third Hospital, Beijing 100191, China)

机构地区：[1]北京大学第三医院耳鼻咽喉科,北京100191 [2]北京大学第三医院临床流行病学研究中心

出　　处：《中国微创外科杂志》2020年第12期1118-1122,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学第三医院优秀留学回国人员科研启动基金(LXHG2018002)。

摘　　要：目的探讨内镜辅助经口低温等离子手术治疗茎突综合征的效果。方法回顾性分析2010年2月~2020年4月经口扁桃体窝入路低温等离子手术治疗茎突综合征50例(60侧)的临床资料,其中2016年5月后16例采用内镜辅助。CT显示60侧茎突长度(35.42±8.66)mm(23~72.3 mm)。其中3例茎突不连续,1例茎突骨质欠规整、粗细不均,2例茎突舌骨韧带骨化,1例茎突舌骨肌骨化。结果术野暴露满意率内镜组87.5%(14/16),传统组70.6%(24/34)(χ^2=0.905,P=0.341)。茎突截短长度内镜组(14.28±9.21)mm(7~40 mm),传统组(12.63±6.02)mm(0.5~25 mm)(t=0.680,P=0.500);内镜组术中出血量中位数6.5 ml(1~30 ml),传统组7.5 ml(1~60 ml)(Z=-0.285,P=0.776)。内镜组术后均未出现出血、咽喉间隙感染等并发症;传统组1例扁桃体窝出血。术后随访6个月,内镜组治愈率66.7%(8/12),有效率100%(12/12);传统组治愈率34.5%(10/29),有效率55.2%(16/29)。内镜组有效率明显高于传统组(P=0.007)。结论内镜辅助行经口低温等离子茎突手术术野暴露好,并发症少,效果满意。Objective To analyze and discuss the clinical effect of temperature-controlled radiofrequency surgery assisted by oral endoscopy for styloid process syndrome.Methods Clinical data of 50 patients(60 sides)with styloid process syndrome treated by transoral tonsillar fossa approach with temperature-controlled radiofrequency surgery from February 2010 to April 2020 were analyzed retrospectively.There were 16 patients treated with endoscopic approach after May 2016.The CT showed that the length of styloid process affected in 60 sides was(35.42±8.66)mm(range,23-72.3 mm).Among them,there were 3 cases of discontinuous styloid process,1 case of irregular and uneven styloid process bone,2 cases of ossifichyoid ligament,and 1 case of ossific hyoid muscle.Results The satisfaction rate of surgical field exposure was 87.5%(14/16)in endoscopic group and 70.6%(24/34)in traditional group(χ^2=0.905,P=0.341).The length of truncated styloid process was(14.28±9.21)mm(range,7-40 mm)in endoscopic group and(12.63±6.02)mm(range,0.5-25 mm)in traditional group(t=0.680,P=0.500);the median intraoperative blood loss was 6.5 ml(range,1-30 ml)in endoscopic group and 7.5 ml(range,1-60 ml)in traditional group(Z=-0.285,P=0.776).There were no complications such as bleeding and pharynx and larynx space infection in endoscopic group,and 1 case of tonsillar fossa hemorrhage in traditional group.After 6 months of follow-up,the cure rate and effective rate were 66.7%(8/12)and 100%(12/12)in endoscopic group,and 34.5%(10/29)and 55.2%(16/29)in traditional group.The effective rate of endoscopic group was significantly higher than that of traditional group(P=0.007).Conclusion Endoscopic assisted transoral temperature-controlled radiofrequency styloid process surgery has the advantages of better exposure of operation field,less postoperative complications,and satisfactory results.

关 键 词：茎突综合征 茎突截短术 经口入路 内镜 低温等离子射频 

分 类 号：R47[医药卫生—护理学]