原发性咽旁间隙肿瘤38例临床诊治分析  

Clinical diagnosis and treatment analysis of 38 cases of primary parapharyngeal space tumors

作　　者：廖佳兴 冯华君 廖江雪 梁琦栩 覃纲 LIAO Jiaxing;FENG Huajun;LIAO Jiangxue;LIANG Qixu;QIN Gang(Department of Otolaryngology Head and Neck Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan,646000,China)

机构地区：[1]西南医科大学附属医院耳鼻咽喉头颈外科,四川泸州646000

出　　处：《中国耳鼻咽喉头颈外科》2024年第4期205-209,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨原发性咽旁间隙肿瘤的临床特点和手术治疗方法。方法回顾性分析2005年6月~2023年4月期间于西南医科大学附属医院诊治的38例原发性咽旁间隙肿瘤患者的临床资料,分析其临床表现、影像学资料、手术方式、术后并发症、术后病理类型及预后。结果38例患者临床表现主要为咽部不适和咽部膨隆。CT、MRI检查可明确肿瘤的大小、位置及与周围组织的关系。手术方式包括经颈侧入路17例,经口入路15例,经颈-腮腺入路4例,经颈-下颌骨裂开入路2例。术后并发症主要为神经功能障碍。术后病理诊断良性肿瘤28例(73.7%),恶性肿瘤10例(26.3%)。术后随访2个月~17年,良性肿瘤患者均无复发,恶性肿瘤患者经手术加放化疗的综合治疗后均存活良好。结论原发性咽旁间隙肿瘤患者大多无特异性临床症状,病理类型多样。选择合适的手术入路切除肿瘤是治疗的关键。神经功能障碍是术后最主要的并发症。良性肿瘤患者术后远期效果较好,恶性肿瘤患者手术加放化疗的综合治疗有较好的疗效。OBJECTIVE To explore the clinical features and surgical treatment methods of primary parapharyngeal space tumors.METHODS The clinical data of 38 patients with primary parapharyngeal space tumors who were treated in the Affiliated Hospital of Southwest Medical University from June 2005 to April 2023 were retrospectively analyzed,and their clinical manifestations,imaging data,surgical methods,postoperative complications,postoperative pathological types and prognosis were analyzed.RESULTS The clinical manifestations of 38 patients were mainly pharyngeal discomfort and pharyngeal distension.CT and MRI can determine the size,location,and relationship of the tumor to surrounding tissue.The surgical methods included transcervical approach in 17 cases,transoral approach in 15 cases,transcervical-transparotid approach in 4 cases,and transcervical-transmandibular approach in 2 cases.Postoperative pathology diagnosed 28 cases(73.7%)of benign tumors and 10 cases(26.3%)of malignant tumors.After the postoperative follow-up of 2 months-17 years,there was no recurrence of benign tumor patients,and patients with malignant tumors survived well after comprehensive treatment with surgery and radiotherapy and chemotherapy.CONCLUSION Most patients with primary parapharyngeal space tumors have no specific clinical symptoms,and the types of pathologies are diverse.Choosing the appropriate surgical approach to remove the tumor is key to treatment.Neurologic deficits are the most important postoperative complication.Patients with benign tumors have good long-term effects after surgery,and patients with malignant tumors have better efficacy in the combination of surgery and chemoradiotherapy.

关 键 词：咽旁间隙肿瘤 诊断 外科手术 

分 类 号：R739.63[医药卫生—肿瘤]