山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 38-41.doi: 10.6040/j.issn.1673-3770.0.2015.094

• 论著 • 上一篇    下一篇

口内径路咽旁间隙的内镜解剖结构

张宝莹1,2, 卢永田1, 李建兴3   

  1. 1. 深圳市第二人民医院耳鼻咽喉科, 广东 深圳 518035;
    2. 广州医科大学研究生院, 广东 广州 510450;
    3. 深圳市龙华新区中心医院耳鼻喉科, 广东 深圳 518110
  • 收稿日期:2015-02-16 修回日期:2015-04-10 出版日期:2015-08-16 发布日期:2015-08-16
  • 通讯作者: 卢永田。E-mail:luyongtian@263.net E-mail:luyongtian@263.net
  • 作者简介:张宝莹。E-mail:893960422@qq.com

Transoral endoscopic dissection of parapharyngeal space.

ZHANG Baoying1,2, LU Yongtian1, LI Jianxing3   

  1. 1. Department of Otolaryngology, Shenzhen Second People's Hospital, Shenzhen 518035, Guangdong, China;
    2. Graduate School of Guangzhou Medical University, Guangzhou 510450, Guangdong, China;
    3. Department of Otolaryngology, Central Hospital of Longhua New District, Shenzhen 518110, Guangdong, China
  • Received:2015-02-16 Revised:2015-04-10 Online:2015-08-16 Published:2015-08-16

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摘要： 目的 研究口内径路咽旁间隙的内镜解剖结构, 了解颈内动、静脉及后组颅神经等解剖结构的毗邻关系, 为内镜下口内径路咽旁间隙肿瘤切除提供解剖依据。方法 对新鲜尸头5例(共10侧), 进行内镜下经口内径路咽旁间隙解剖。结果 咽上缩肌是进入茎突前间隙的标志, 茎突咽肌、茎突舌肌是进入茎突后间隙的标志, 茎突后间隙包含重要的血管及后组颅神经。结论 内镜下口内径路可充分暴露咽旁间隙的结构, 茎突咽肌、茎突舌肌是保护茎突后间隙的重要解剖标志。颈内动脉位于咽上缩肌的外侧, 靠近咽上缩肌内侧能够保护颈内动脉。

关键词: 内镜下口内径路, 咽旁间隙, 颈内动脉, 解剖

Abstract: Objective To investigate the transoral anatomic characteristics of parapharyngeal space. Methods A total of 5 fresh cadaver heads (including 1 injected cadaver head) were dissected to illustrate the transoral approach of parapharyngeal space anatomy. Results The superior constrictor muscle was the landmark to enter the prestyloid space. The stylopharyngeus and styloglossus muscles were critical marks which divided the parapharyngeal space into 2 parts. Posterior to these muscles and laterally to the superior constrictor muscle, the internal carotid artery, internal jugular vein, and lower cranial nerves were identifiable. Conclusion Our dissection emphasizes the role of the stylopharyngeus and styloglossus muscles. The lateral surface of the superior constrictor muscle is essential to protect the internal carotid artery.

Key words: Anatomy, Parapharyngeal space, Internal carotid artery, Transoral endoscopic approach

中图分类号: 

  • R766.9
[1] Singh M, Gupta S C, Singla A. Our experiences with parapharyngeal space tumors and systematic review of the literature[J]. Indian J Otolaryngol Head Neck Surg, 2009, 61(2):112-119.
[2] Cassoni A, Terenzi V, Della M M, et al. Parapharyngeal space benign tumors:our experience[J]. J Craniomaxillofac Surg, 2014, 42(2):101-105.
[3] Eisele D E, Netterville J L, Hoffman H T, et al. Parapharyngeal space masses[J]. Head Neck, 1999, 21(2):154-159.
[4] 杨立新, 廉养德, 王玖华. 鼻咽癌咽旁间隙侵犯的CT诊断评价[J]. 临床放射学杂志, 1998, 17(1):23-25. YANG Lixin, LIAN Yangde, WANG Jiuhua, et al. Involvement of parapharyngeal space in nasopharyngeal carcinoma: evaluation with CT[J]. J Clin Radiol, 1998, 17(1):23-25.
[5] 江桂华, 章志霖, 田军章, 等. 舌骨上颈部筋膜间隙MR成像[J]. 放射学实践, 2001, 16(1):23-26. JIANG Guihua, ZHANG Zhilin, TIAN Junzhang, et al. MR imaging of facial spaces in suprahyoid neck region[J]. Radiol Practice, 2001, 16(1):23-26.
[6] Yousem D M. Kraut M A, Chaliam A A. Major salivary gland imaging[J]. Radiol, 2000, 216(1):19-29.
[7] Khafif A, Segev Y, Kaplan D M, et al. Surgical management of parapharyngeal space tumors: a 10-year review[J]. Otolaryngol Head Neck Surg, 2005, 132(3):401-406.
[8] 罗兴谷, 卢永田, 王晓彬. 内镜下经口径路咽旁间隙肿瘤摘除5例[J]. 山东大学耳鼻喉眼学报, 2014, 28(4):56-58. LUO Xinggu, LU Yongtian, WANG Xiaobin, et al. Surgical treatment of parapharyngeal space tumors via endoscopic transoral approach: a retrospective analyses of 5 cases[J]. J Otolaryngol Ophthalmol Shangdong Univ, 2014, 28(4):56-58.
[9] Eisele D W, Richmon J D. Contemporary evaluation and management of parapharyngeal space neoplasms[J]. J Laryngol Otol, 2013, 127(6):550-555.
[10] Stambuk H E, Patel S G. Imaging of the parapharyngeal space[J]. Otolaryngol Clin North Am, 2008, 41(1):77-101.
[11] 张俊毅, 谢志海, 章华, 等. 经茎突隔膜入路切除咽旁间隙肿瘤[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(8):654-657. ZHANG Junyi, XIE Zhihai, ZHANG Hua, et al. Resection of parapharyngeal neoplasms via styloid diaphragm approach[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(8):654-657.
[12] Miller F R, Wanamaker J R, Lavertu P, et al. Magnetic resonance imaging and the management of parapharyngeal space tumors[J]. Head Neck, 1996, 18(1):67-77.
[13] Dallan I, Seccia V, Muscatello L, et al. Transoral endoscopic anatomy of the parapharyngeal space: a step-by-step logical approach with surgical considerations[J]. Head Neck, 2011, 33(4):557-561.
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