山东大学耳鼻喉眼学报 ›› 2014, Vol. 28 ›› Issue (5): 85-90.doi: 10.6040/j.issn.1673-3770.0.2014.159

• 综述 • 上一篇    下一篇

咽旁间隙肿瘤的诊断和治疗

胡娟娟, 洪育明   

  1. 福建医科大学第二临床医学院, 福建 泉州 362000
  • 收稿日期:2014-05-12 发布日期:2014-10-16
  • 通讯作者: 洪育明,教授,主任医师。E-mail:hongym666@sina.com E-mail:hongym666@sina.com
  • 作者简介:胡娟娟。E-mail:2310605332@qq.com

Diagnosis and treatment of parapharyngeal space neoplasms

HU Juan-juan, HONG Yu-ming   

  1. Department of Otorhinolaryngology, the Second Clinical Medical College, Fujian Medical University, Quanzhou 362000, Fujian, China
  • Received:2014-05-12 Published:2014-10-16

摘要: 咽旁间隙解剖结构复杂、肿瘤病理类型繁多,临床表现各异。因此,咽旁间隙肿瘤的诊断和治疗皆较头颈部其他肿瘤困难。双合诊、影像学检查、细针穿刺细胞学、经口或经颈活检等综合诊断方法,可判定肿瘤性质、血液供给,了解肿瘤与周围重要组织的关系,为制定治疗方案提供可靠依据。就咽旁间隙肿瘤的临床诊断及治疗,尤其是手术径路的选择作了综述。

关键词: 头颈部肿瘤, 咽旁间隙, 诊断, 治疗

Abstract: Anatomy of parapharyneal space is very complicated. Many types of parapharyngeal space neoplasms can occur, and all of them demonstrate different clinical manifestations. Therefore, it is more difficult to diagnose and treat the parapharyngeal space neoplasms than other head and neck neoplasms. Common diagnostics methods include bimanual examination, imaging studies, cytopathology, transoral and transcervical biopsy. All these methods can help doctor determine the nature and blood supply of tumors and understand the relationship between neoplasms and adjacent structure, which provide a reliable basis for the ensuing treatment. This paper aims to state the diagnosis and treatment of parapharyngeal space neoplasms, especially how to select surgical procedures.

Key words: Diagnosis, Treatment, Parapharyngeal space, Head and neck tumours

中图分类号: 

  • R762
[1] Almela Cortés R, Aldasoro Martín J, Gozalbo Navarro J M. Parapharyngeal space tumours: Presentation of three cases and literature review[J]. An Otorrinolaringol Ibero Am, 2003, 30(3):265-275.
[2] Curtin H D. Separation of the masticator space from the parapharyngeal space[J]. Radiology, 1987, 163(1):195-204.
[3] Chong V F, Fan Y F. Radiology of the parapharyngeal space[J]. Aust Rodio, 1998, 42(3):278-283.
[4] 刘方舟,董明敏,张园,等.咽旁间隙原发肿瘤69例临床病理与解剖分析[J].临床耳鼻咽喉头颈外科杂志,2009,2(3):113-118. LIU Fangzhou, DONG Mingmin, ZHANG Yuan, et al. Clinical pathology and anatomy features of parapharyngeal region neoplasms:a report of 69 cases[J]. J Clin Otolaryngol Head Neck Surgery, 2009, 2 (3):113-118.
[5] Batsakis J G, Sneige N. Parapharyngeal and retropharyngeal space diseases[J]. Ann Otol Rhinol Laryngol, 1989, 98(4 Pt 1):320-321.
[6] Pensak M L, Gluckman J L, Shumrick K A. Parapharyngeal space tumors: an algorithm for evaluation and management[J]. Laryngoscope, 1994, 104(9):1170-1173.
[7] Carrau R L, Johnson J T, Myers E N. Management of tumors of the parapharyngeal space[J]. Oncology, 1997, 11(5):633-640.
[8] Cohen S M, Burkey B B, Netterville J L. Surgical management of parapharyngeal space masses[J]. Head Neck, 2005, 27(8):669-675.
[9] Shahab R, Heliwell T, Jones A S. How we do it: a series of 114 primary pharyngeal space neoplasms[J]. Clin Otolaryngol, 2005, 30(4):364-367.
[10] Luna-Ortiz K, Navarrete-Alemán J E, Granados-García M, et al. Primary parapharyngeal space tumors in a Mexican cancer center[J]. Otolaryngol Head Neck Surg, 2005, 132(4):587-591.
[11] Shahab R, Heliwell T, Jones A S. How we do it: a series of 114 primary pharyngeal space neoplasms[J].Clin 0tolaryngol, 2005, 30(4):364-367.
[12] Patetsios P, Gable D R, Garrett W V, et al. Management of carotid body paraganglioma and review of a 30-year experience[J]. Ann Vasc surg, 2002, 16(3):331-338.
[13] Farrag T Y, Lin F R, Koch W M, et al. The role of pre-operative CT-guided FNAB for parapharyngeal space tumors[J]. Otolaryngol Head Neck Surg, 2007, 136(3):411-414.
[14] 刘绍严.颈部肿瘤[M]//屠规益,徐国镇.头颈恶性肿瘤的规范性治疗.北京:人民卫生出版社,2003:246-241.
[15] Gupta A, Chazen J L, Phillips C D. Imaging evaluation of the parapharyngeal space[J]. Otolaryngol Clin North Am, 2012, 45(6):1223-1232.
[16] Saito D M, Glastonbury C M, El-Sayed I H, et al. Parapharyngeal space schwannomas:preoperative imaging determination of the nerve of origin[J]. ArchOtotolaryngol Head Neck Surg, 2007, 133(7):662-667.
[17] Oliai B R, Sheth S, Burroughs F H, et al.“Parapharyngeal space”tumors: a cytopathological study of 24 cases on fine-needle aspiration[J]. Diagn Cytopathol, 2005, 32(1):11-15.
[18] Ducic Y, Oxford L, Pontius A T. Transoral approach to the superomedial parapharyngeal space[J]. Otolaryngol Head Neck Surg, 2006, 134(3):466-470.
[19] Hart D M, Ferlito A, Silver C E, et al. Milimally invasive tecniques for head and neck malignancies: Current indictions,outco mes and future directions[J]. Eur Arch Otorhinolaryngol, 2011, 268(9):1249-1257.
[20] Rigby M H,Taytor S M. Review of transoral laser microsurgery for cancer of the uper aerodigestive tract[J]. J Otolaryngol Head Neck Surg, 2011, 40(2):113-121.
[21] Arshad H, Durmus K, Ozer E. Transoral robotic resection of selected parapharyngeal space tumors[J]. Eur Arch Otorhinolaryngol, 2013, 270(5):1737-1740.
[22] Lee H S, Kim J, Lee H J, et al. Transoral robotic surgery for neurogenic tumorsof the prestyloid parapharyngeal space[J]. Auris Nasus Larynx, 2012, 39(4):434-437.
[23] De Virgilio A, Park Y M, Kim W S, et al. Transoral robotic surgery for the resection of parapharyngeal tumour:our experience in ten patients[J]. Clin Otolaryngol, 2012, 37(6):483-486.
[24] Betka J, Chovanec M, Klozar J, et al.Transoral and combined transoral-transcervical approach in the surgery of parapharyngeal tumors[J]. Eur Arch Otorhinolaryngol, 2010, 267(5):765-772.
[25] Chang S S, Goldenberg D, Koch W M. Transcervical approach to benign parapharyngeal space tumors[J]. Ann Otol Rhinol Laryngol, 2012, 121(9):620-624.
[26] Papadogeorgakis N 1, Petsinis V, Goutzanis L, et al. Parapharyngeal space tumors:Surgical approaches in a series of 13 cases[J]. Int J Oral Maxillofac Surg, 2010, 39(3):243-250.
[27] 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 Surgery, 2013, 48(8):654-657.
[28] Hughes K V, Olsen K D, Mc Caffrey T V. Parapharyngeal space neoplasms[J]. Head Neck, 1995, 17(2):124-130.
[29] 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.
[30] 陈雷,王刚,王荣光.鼻内镜下颅底占位性病变的微创手术[J].中华耳鼻咽喉头颈外科杂志,2007,42(5):341-344. CHEN Lei, WANG Gang, WANG Rongguang. Endoscopic surgery in occupation lesions of the skull base[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2007, 42 (5):341-344.
[31] 刘善,杜伟,冯露,等.咽旁间隙肿瘤的影像学诊断与手术入路的选择[J].中华口腔医学杂志,2013,45(5):308-320. LIU Shan, DU Wei, FENG Lu, et al. Diagnosis and operation approach of parapharyngeal space tumor[J]. Chin J Stomatol, 2013, 45(5):308-320.
[32] Jungehuelsing M, Guntinas-Lichius O, Klussmann J P, et al. Modifications of the midline mandibulotomy for access to the parapharyngeal space[J]. Laryngoscope, 2010, 120(8):1557-1562.
[33] Bozza F, Vigili M G, Ruscito P, et al. Surgical management of parapharyngeal space tumours: results of 10-year follow-up[J]. Acta Otorhinolaryngol Ital, 2009, 29(1):10-15.
[34] Zhi K, Ren W, Zhou H, et al. Management of parapharyngeal-space tumors[J]. J Oral Maxillofac Surg, 2009, 67(6):1239-1244.
[35] Senft C, Franz K, Blasel S, et al. Influence of iMRI-guidance on the extent of resection and survival of patients with glioblastoma multiforme[J]. Technol Cancer Res Treat, 2010, 9(4):339-346.
[36] Chicoinc M R, Lim C C, Evans J A, et al. Implementation and preliminary clinical experience with the use of ceiling mounted mobile high field intraoprative magnetic renonance imaging between two operating rooms[J]. Acta Neurochir Suppl, 2011, 109:97-102.
[37] Ganly I, Patel S G, Sinsh B, et al. Craniofacial resection for Malignant tumors involving the skull base in the elderly: an intenational collaborative study[J]. Cancer, 2011, 117(3):563-571.
[38] 张建国,张杰,宋铁砾,等.放射性粒子组织间植入治疗口腔颌面部恶性肿瘤初探[J].中华口腔医学杂志,2006,41(8):464-466. ZHANG Jianguo, ZHANG Jie, SONG Tieli, et al. Radioactive seed implantation in treatment of oral and maxillofacial malignancy[J]. Chin J Stomatol, 2006, 41 (8):464-466.
[39] Di Maio S, Temkin N, Ramanathan D, et al. Current comprehensive Management of cranialbase chordomas:10-year meta-analysis of observational studies[J]. J Neurosurg, 2011, 115(6):1094-1105.
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