摘要
目的 :探讨咽旁间隙肿瘤手术并发症的预防措施。方法 :4 1例咽旁间隙肿瘤患者行手术治疗 ,经口入路 6例 ,腮腺径路 6例 ,经颈外径路切除 2 5例 ,颈外加下颌骨切断 2例 ,侧颅底径路 2例。术中气管切开 8例。4例部分切除肿瘤 ,37例完全切除肿瘤。结果 :术腔感染 2例。永久性神经损伤有 :Horner综合征 2例 ;其他神经损伤 5例 ,主要为Ⅶ、Ⅸ、Ⅹ、Ⅺ脑神经损伤。 1例巨大神经鞘瘤并发大出血。随访 11个月～ 6年 ,复发 6例 ,1例为口咽径路的良性肿瘤 ,5例为恶性肿瘤。结论 :熟悉咽旁间隙解剖 ,详细的术前评估 ,合理的手术径路和完善的术腔处理是避免并发症的重要条件。
Objective:To explore the prevention of complications during the the paralaryngeal space(PPS) neoplasms surgery.Method:A retrospect study was carried out from 41 patients, suffering from paralaryngeal space neoplasms and recerving surgery from 1990 to 2002. The surgical procedures included oral approach in 6 cases, parotid approach in 6 cases, cervical approach in 25 cases, cervical approach with mandibular swing in 2 cases and lateral skull base approach 2 in cases. Eight cases got the tracheodectomy during the operations. The tumor in 37 cases were resected throughly, except for 4 cases with partial resection.Result:The patients were followed up for 11 months to 6 years. The surgical complications consists of surgical cavity infections in 2 cases, a massive bleeding in 1 case with huge nerve sheath tumor and permanent nerves damage in 7 cases, including Horner's syndrome(2 cases) and nerves damage(5 cases),such as Ⅶ、Ⅸ、Ⅹ and Ⅺ. Six cases relapsed: 1 cases with benign tumor through oral approach and 5 cases with malignant neoplasms.Conclusion:Familiarity with PPS anatomy, preoperational evaluation in detail, proper surgery approach and perfect treatment during the operation are vital important to avoid the complications in PPS neoplasms.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2004年第6期343-345,共3页
Journal of Clinical Otorhinolaryngology
关键词
咽肿瘤
手术
并发症
Pharyngeal neoplasms
Surgery
Complication
