摘要
目的 寻求颞下窝咽侧区肿瘤的早期诊断及有效的手术途径。方法 1978～ 2 0 0 2年我院手术治疗颞下窝咽侧区肿瘤 75例。手术采用 4种进路 :①颌下进路。②截断下颌骨颌下联合进路。③耳前颌下进路。④经上颌窦前外进路。绝大多数采用第 1种手术入路。恶性肿瘤术后行放疗或化疗 ;继发性肿瘤在切除原发性肿瘤的同时予以切除。结果 手术效果良好 ,无并发症。良性肿瘤 38例术后 6个月～ 18年 (其中 2 6例超过 5年以上 ) ,1例复发。恶性肿瘤 37例中 ,12例死亡 ,5例失访 ,余 2 0例观察 3～ 5年无复发及转移。结论 ①颞下窝咽侧区肿瘤CT扫描及针吸细胞病理检查是有效的诊断手段。②颌下进路是该区肿瘤较好的手术途径。③术中彻底止血、尽可能消灭死腔及负压引流对预防切口感染和预防呼吸道阻塞都相当重要。
Objective To study the early diagnosis and treatment for the infratemparal and parapharynx tumor, and to find the better surgery approach to the area. Methods Since 1978, 75 patients with infratemporal fossa and parapharynx tumor have been treated in our hospital..four operative approaches used are as follows: ①submandibulla approach; ②submandibulla combined approach with cutting mandibulla bone; ③preauricullar submandibulla approach; ④anterior lateral transantral approach. Of these, most of them is the first, followed by the second. The patients with malignant tumor received radiotherapy and chemitherapy after operaration. The secondary tumor was removed during removing the primary one. Results According to follow up, the operative results are satisfactory. There is not any operative complication. Of 38 cases for benign tumor in 0.5～18 years after operation, only one recurrenced (26 cases are over 5 ysars). Of 37 cases for malignant tumor 12 cases died, 5 cases lost information,20 cases have not recurrenced and metastasis for 3 to 5 years. Conclusion ① CT scan and cells pathology with needle penetration for the infratemporal fossa and parapharynx tumor are very effective methods of diagnosis. ②Submandibulla approach is a better operative approach for this area tumor. ③Stoping bleeding thoroughly, preventing the obstruction of the respiratory duct, and eliminating dead space and draining of negtive pressure are all very important.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2004年第1期15-17,共3页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
