内镜辅助经唇龈沟入路腭部多形性腺瘤切除术  

Endoscopic-assisted resection of palatal pleomorphic adenoma via labiogingival groove approach

作　　者：饶远生[1] 王建宏[1] 贾弘光[1] 冯燕军 杨帆[1] 倪鑫[2] RAO Yuansheng;WANG Jianhong;JIA Hongguang;FENG Yanjun;YANG Fan;NI Xin(Department of Otolaryngology Head and Neck Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,China;Department of Otolaryngology Head and Neck Surgery,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing,100045,China)

机构地区：[1]首都医科大学附属北京安贞医院耳鼻咽喉头颈外科,北京100029 [2]国家儿童医学中心,首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045

出　　处：《中国耳鼻咽喉头颈外科》2021年第4期226-229,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨内镜辅助经唇龈沟入路联合传统硬腭入路切除腭部多形性腺瘤的可行性及疗效。方法采用内镜辅助经唇龈沟入路联合传统硬腭入路切除累及鼻底、硬腭上表面及牙槽骨的腭部多形性腺瘤7例,男3例,女4例;年龄22~61岁,平均年龄42岁。结果 6例包膜外完整切除肿瘤,1例术中瘤体有破损,包膜外切除后予大量生理盐水冲洗并尽可能切除术区除鼻底黏膜外的软组织。术后病理均为多形性腺瘤。随访时间18~78个月,平均为37个月,术后患者症状消失,未出现口鼻瘘、吞咽障碍、构音障碍等并发症。术后随访至今均无复发。结论内镜经唇龈沟入路联合传统硬腭入路切除腭部多形性腺瘤,特别是累及鼻底、硬腭及牙槽骨的病例,是安全、有效、微创的,值得临床推广应用。OBJECTIVE To investigate the feasibility and curative effect of resection the palatal pleomorphic adenoma via endoscopic labiogingival groove approach combined with traditional hard palatal approach.METHODS Seven cases of palatal pleomorphic adenoma involving the nasal floor,the upper surface of the hard palate and the alveolar bone were operated by endoscopic assistance through the labiogingival groove approach combined with the traditional hard palate approach.There were 3 male and 4 female,and the age was 22 to 61 years old,with an average age of 42 years old.RESULTS Use of extracapsular dissection,the tumor was removed completely in 6 patients,and the tumor was ruptured during the operation in one patient.A large amount of normal saline was used to rinse and as far as possible to remove the soft tissue except the nasal floor mucosa.The postoperative pathology was pleomorphic adenoma.The follow-up time was 18-78 months,the average was 37 months.The symptoms disappeared after operation and no complications such as oronasal fistula,dysphagia and dysarthria occurred.No recurrence was found in the follow-up.CONCLUSION It is a safe,effective and minimally invasive surgical approach for the removal of palatal pleomorphic adenoma,especially for the cases involving nasal floor,hard palate and alveolar bone,and is worthy of clinical application.

关 键 词：腺瘤 多形性 内窥镜检查 外科手术 唇龈沟入路 腭部 

分 类 号：R739.8[医药卫生—肿瘤]