摘要
目的:探讨咽旁间隙肿瘤诊断及手术入路的合理选择。方法:对1998～2006年收治的24例咽旁间隙肿瘤病例资料的临床表现、病理类型、手术入路进行回顾性分析。所有患者均采用手术治疗,手术入路采用颈侧入路、经颈腮腺入路、经颈颌入路。术后随访1～10a。结果:临床表现无特异性,多以颈部或咽侧包块就诊,可伴有发音、吞咽等功能障碍。24例咽旁间隙肿瘤患者中,良、恶性肿瘤分别占87.5%和12.5%。病理类型以腮腺来源和神经源性肿瘤最为常见。CT、MRI能清楚显示肿块的大小、形态、位置、与周围结构的关系,对手术入路的选择有重要参考意义。24例全部行手术治疗,经颈侧入路10例,经颈腮腺入路10例,经颈颌入路4例。1例死亡,2例失访,其余患者全部治愈,随访期间无复发。结论:CT、MRI可作为明确诊断和手术入路选择的重要参考依据。以颈侧入路为基础,根据肿瘤的大小、来源和性质,再采用颈腮腺、颈颌入路,是合理的手术入路。
PURPOSE： The aim of this study is to investigate the diagnosis and reasonable surgical approach for parapharyngeal space neoplasms. METHODS： A retrospective study was carried out from the data of 24 patients, who suffered from paralaryngeal space neoplasms and underwent surgical treatment from 1998 to 2006. The follow- up was carried out from 1 to 10 years. RESULTS： The patients had no specific symptoms initially. Most patients visited the doctor with cervical or submandibular masses and some of them with disorders of swallowing or speech. 87.5% of the neoplasms were benign and 12.5% were malignant. Neurogenic tumors and tumors originating from the parntid gland accounted the most. CT or MRI provided useful information such as their sizes, shapes, extents and the relationship between the neoplasm and surrounding tissues. The trans-cervical approach was used in 10 cases, the trans-parotid approach in 10 cases, the trans-mandible approach in 4 cases. One patient was dead, two patients were lost to follow up, the others had been cured without recurrence. CONCLUSIONS： CT and/or MRI are essentially useful tools for diagnosis and presurgical planning. Based on the trans-cervical approach, according to the size, origination and nature of the neoplasms, choose of the trans-parotid or the transmandibular approach for surgical treatment is reasonable.Supported by Natural Scientific Research Plan of Shanxi Province of China [Grant No.2006k09-G3（5） and 2005K14-G8（2）].
出处
《上海口腔医学》
CAS
CSCD
2007年第5期547-550,共4页
Shanghai Journal of Stomatology
基金
陕西省科技攻关项目[2006k09-G3(5)和2005K14-G8(2)]
关键词
咽旁间隙
肿瘤
诊断
手术径路
Parapharyngeal space
Neoplasm
Diagnosis
Surgical approach
