摘要
目的探讨经颈侧腮腺手术径路与口内上颌结节手术径路切除巨大咽旁间隙肿瘤的疗效。方法回顾分析2007年10月-2014年10月收治的17例在本院临床诊断为咽旁间隙巨大肿瘤患者的临床资料。分析手术径路的选择、并发症和预后等。结果17例肿瘤最大径〉5cm，其中10例（59％）采用经颈侧腮腺径路，7例（41％）采用经口内上颌结节径路。术后病理诊断为多形性腺瘤6例、神经鞘瘤6例、黏液表皮样癌l例、甲状腺乳头状癌转移1例、淋巴上皮癌1例、节细胞神经瘤1例、神经纤维瘤1例。术后随访3个月-6年，1例黏液表皮样癌及1例淋巴上皮癌术后补充放疗，1例甲状腺癌转移行甲状腺全切除后行放射性核素放疗。3例经颈侧腮腺入路者术后出现轻度口角歪斜，3-6个月后完全恢复；1例腮腺混合瘤和1例神经鞘瘤复发；其余12例随访至今未见复发。结论位于咽旁间隙中下区的巨大肿瘤，可采用经颈侧腮腺手术径路；对于咽旁间隙内侧或中上区域的巨大肿瘤，经口径路较为理想。
Objective To evaluate the efficacy of the surgical approach through the side of the neck and the upper jaw on large parapharyngeal apace tumors. Methods Data of 17 patients of large parapharyngeal space tumor admitted to the hospital from Oct. 2007 to Oct. 2014 were analyzed retrospectively, including the surgical approach, complications and prognosis, etc. Results The largest diameter of the tumors was 〉 5 cm in all patients. Ten cases were treated through the cervical side parotid gland and 7 cases were treated through the internal maxillary approach. The postoperative pathological diagnosis of pleomorphic adenoma was as follows： 6 cases of pleomorphic adenoma,6 cases of neurilemmoma, 1 case of mucoepidermoid carcinoma, 1 case of thyroid cancer, 1 case of lymphoepithelial carcinoma, 1 case of ganglioneuroma and 1 case of neurofibroma. All patients were followed up for 3 months to 6 years. One case of mucoepidermoid carcinoma and 1 case of lymphoepithelial carcinoma underwent postoperative radiotherapy, 1 case of thyroid cancer underwent total thyroidectomy and isotope radiotherapy. Tumor recurrence occured in patients with pleomorphic adenoma and neurilemmoma, and 3 cases of transcervieal plus transparotid approach showed mild mouth skew and fully recovered after 3 to 6 months. No tumor recurrence were found in the left 12 cases. Conclusions Transcervical plus transparotid approach is available to the large tumors in the lower part of parapharyngeal space. The maxillary tubercle approach is more ideal for the tumors in the upper part of parapharyngeal space.
出处
《中国眼耳鼻喉科杂志》
2016年第5期343-344,346,共3页
Chinese Journal of Ophthalmology and Otorhinolaryngology
关键词
咽旁间隙
手术径路
肿瘤
Parapharyngeal space
Surgical approach
Tumor
