原发性咽旁间隙肿瘤67例回顾性分析

doi:10.6040/j.issn.1673-3770.0.2021.429

摘要/Abstract

摘要： 目的分析原发性咽旁间隙肿瘤的临床特点及手术径路选择,探讨不同手术径路的优缺点及预后。方法回顾性分析67例咽旁间隙肿瘤患者资料,所有患者术前均行CT和(或)MRI检查,三种手术路径分别为颈侧径路45例、口内径路20例、颈-腮径路2例。术后病理学检查明确诊断,对所有手术患者进行术后定期随访,随访时间8~110个月,中位随访时间45个月。结果 67例中良性肿瘤共59例(88.1%),恶性肿瘤8例(11.9%);24例(35.8%)患者出现术后并发症,其中颈侧径路20例(29.9%),口内径路3例(4.5%),颈-腮径路1例(1.5%),其中7例(10.4%)随访后好转。复发患者7例(10.4%),颈侧径路4例(6.0%),口内径路3例(4.5%)。结论咽旁间隙解剖毗邻复杂,病理类型繁多,肿瘤以良性为主,治疗以手术切除为主。术前根据影像学检查结果,肿瘤大小及解剖关系决定手术径路。颈侧径路仍是咽旁间隙肿瘤切除的首选方法,但在肿瘤最大直径<6 cm并位于动脉内侧的良性肿瘤患者中,可考虑口内径路。

关键词: 咽旁间隙肿瘤, 手术径路, 肿瘤大小, 解剖关系, 影像学表现

Abstract: Objective To analyze the clinical characteristics and surgical approaches of parapharyngeal space tumors and to explore the advantages, disadvantages, and prognosis of surgical approaches. Methods The data of 67 patients with parapharyngeal space tumor admitted to the First Affiliated Hospital from January 2010 to June 2019 were analyzed retrospectively. All patients were examined using CT and /or MRI before operation. Forty-five cases were operated by lateral transcervical approach, 20 cases by trans-oral approach, and two cases by cervical-transparotid approach. All patients were followed up closely after operation. The follow-up time was from 8 months to 110 months(median: 45 months). Results A total of 59 cases(88.1%)were pathological benign tumors, eight cases(11.9%)were malignant tumors, and 24 cases(35.8%)had postoperative complications. Twenty cases underwent lateral transcervical approach(29.9%), three patients(4.5%)had transoral approach, and one patient(1.5%)had cervical-transparotid approach. Seven patients(10.4%)improved after follow-up, and seven patients(10.4%)had relapse. Four patients(6.0%)underwent lateral transcervical approach, and three patients(4.5%)underwent transoral approach. Conclusion Parapharyngeal space tumors are mainly benign, with a complex anatomy and various pathological types. Surgical resection serves as the main treatment. According to the results of the imaging examination, tumor size and anatomical relationship determine the approach prior to surgery. The lateral transcervical approach is still the preferred method for resection of parapharyngeal space tumors, but in patients with benign tumors with a maximum tumor diameter of <6 cm and located medical to the artery, the transoral approach can be considered.

Key words: Parapharyngeal space tumor, Surgical approach, Tumor size, Anatomic relationship, Imaging features

中图分类号:

R762

龚霄阳,李旺,陈曦. 原发性咽旁间隙肿瘤67例回顾性分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 60-65.

GONG Xiaoyang, LI Wang, CHEN Xi. Retrospective analysis of 67 cases of primary parapharyngeal space tumors[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 60-65.

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