山东大学耳鼻喉眼学报 ›› 2014, Vol. 28 ›› Issue (4): 56-58.doi: 10.6040/j.issn.1673-3770.0.2013.291

• 论著 • 上一篇    下一篇

内镜下经口径路咽旁间隙肿瘤摘除5例

罗兴谷1,2, 卢永田1, 王晓彬1   

  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
  • 收稿日期:2013-10-15 出版日期:2014-08-16 发布日期:2014-08-16
  • 通讯作者: 卢永田。E-mail:luyongtian@263.net E-mail:luyongtian@263.net
  • 作者简介:罗兴谷。E-mail:arswrdne@163.com

Surgical treatment of parapharyngeal space tumors via endoscopic transoral approach:a retrospective analyses of 5 cases

LUO Xing-gu1,2, LU Yong-tian1, WANG Xiao-bin1   

  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
  • Received:2013-10-15 Online:2014-08-16 Published:2014-08-16

摘要: 目的 探讨内镜下经口内径路摘除咽旁间隙肿瘤的适应证、手术技巧和优点。方法 回顾性分析咽旁间隙肿瘤5例患者的病历资料,均在内镜下经口径路摘除。结果 肿瘤摘除完整,出血20~60 mL,无严重并发症发生,术后5 d内出院。随访1~2年,无复发。结论 CT和MRI可较好地反映肿瘤所在位置、大小、范围,以及肿瘤与周围重要结构的关系和肿瘤的可能起源,为术前评估及选择合适的手术径路提供重要的依据。内镜下经口径路能完整切除位于颈动脉鞘内侧的良性肿瘤,且有颈部无瘢痕、并发症少等优点,不适用于包绕颈动脉鞘内结构、位于颈动脉后方及后外侧的肿瘤。

关键词: 内镜下经口径路, 外科手术, 咽旁间隙肿瘤

Abstract: Objective To investigate the surgical indications, technique, and advantages of resection of parapharyngeal space(PPS) tumors through endoscopic transoral approach. Method Retrospective analysis were carried out in 5 parapharyngeal space tumors patients who received endoscopic transoral approach surgery. Results All the tumors were completely removed and the intraoperative blood loss was 20~60 mL. No serious complications occured and all the patiens were discharged in 5 days after the operation. No recurrence was found in a 1-2 years follow-up. Conclusion Preoperative CT and MRI provide useful clinical informations for surgical planning, such as tumor's location, size, state of invasion, the relationship with adjacent structures, and the likely origin. The endoscopic transoral approach is a good procedure to remove the tumors located anteromedially to the carotid sheath, with minimal invasiveness, no scar in the neck and few complication. However, it is not applicable for PPS tumors encasing the internal carotid arteries or located posterior or posterolateral to the carotid sheath, operative

Key words: Parapharyngeal space tumors, Surgical procedures, operative, Transoral approach with endoscopy

中图分类号: 

  • R739.63
[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] Starek I, Mihal V, Novak Z, et al. Pediatric tumors of the parapharyngeal space. Three case reports and a literature review[J]. Int J Pediatr Otorhinolaryngol, 2004, 68(5):601-606.
[3] Cassoni A, Terenzi V, Della M M, et al. Parapharyngeal space benign tumours: our experience[J]. J Craniomaxillofac Surg, 2013.
[4] 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.
[5] Gadre P K, Gadre K S, Halli R C, et al. Mandibular subsigmoid access osteotomy in the management of parapharyngeal space tumors[J]. J Craniofac Surg, 2013, 24(2):579-582.
[6] 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.
[7] Dimitrijević M V, Jesić S D, Krstić A M, et al. Surgical approach to parapharyngeal space tumors[J]. Acta Chir Iugosl, 2011, 58(4):61-66.
[8] Ahn J Y, Kang S Y, Lee C H, et al. Parapharyngeal branchial cleft cyst extending to the skull base: a lateral transzygomatic-transtemporal approach to the parapharyngealspace[J]. Neurosurg Rev, 2005, 28(1):73-76.
[9] 侯敏, 柳春明, 步荣发, 等. 不同类型下颌骨截骨在咽旁肿瘤切除术中的应用[J]. 中国耳鼻咽喉颅底外科杂志, 2005, 11(2):109-111.
[10] Diaz-Gonzalez F J, Padron A, Foncea A M, et al. A new transfacial approach for lesions of the clivus and parapharyngeal space: the partial segmented Le Fort I osteotomy[J]. Plast Reconstr Surg, 1999, 103(3):955-959.
[11] Goodwin W J, Chandler J R. Transoral excision of lateral parapharyngeal space tumors presenting intraorally[J]. Laryngoscope, 1988, 98(3):266-269.
[12] Ducic Y, Pontius A T. Transoral approach to the superomedial parapharyngeal space[J]. Otolaryngol Head Neck Surgery, 2006, 134(3):466-470.
[13] 张庆泉, 栾建刚, 朱宇宏, 等. 侵及颅底的咽旁间隙肿瘤的手术治疗[J]. 山东医大基础医学院学报, 2000, 14(1):10-11.
[14] 田文栋, 李湘平, 李丹凤, 等. 咽旁间隙良性肿瘤的影像学特征及经口手术进路分析[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(21):983-986.
[1] 王丽,张宇,张华,刘雪艳,宋西成. 加速康复外科理念在鼻窦外科手术的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 23-26.
[2] 王春雨,张芬,王贝贝,李宇玥,王小雨,李志云,张庆泉. 喉白斑32例临床诊治分析及再认识[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 114-116.
[3] 宋西成. 加速康复外科理念在头颈肿瘤手术的应用价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 1-4.
[4] 李华斌, 赖玉婷. 慢性鼻-鼻窦炎的发病机制及诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 4-9.
[5] 张炜,曾昱菡,余先崧. 慢性鼻窦炎手术前后ECP、EGF、IL-6的水平变化及临床意义[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 63-67.
[6] 刘晓静,王愿,张立庆,冯剑,赵青,宋圣花,周涵,董伟达. 鼻窦骨纤维异常增殖症36例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 73-78.
[7] 王愿,周涵,刘晓静,张立庆,赵青,冯剑,董伟达. 鼻内翻性乳头状瘤的术式选择和疗效分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 79-83.
[8] 朱丽. 近期鼻骨与鼻中隔复合外伤鼻内镜下成形术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 7-9.
[9] 李娜. 美容与功能兼顾——浅谈鼻畸形整复与鼻中隔成形术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 1-2.
[10] 吴晴伟,赵影颖,王珮华,王钟颖,陈东. 鼻尖鼻背缺损延期局部皮瓣修复的疗效观察[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 14-17.
[11] 华骋, 陈振雨,张维娜,李娜. 鼻内镜辅助下外鼻整形同期鼻中隔偏曲矫正术[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 33-36.
[12] 姜震,雷大鹏,刘大昱,孙睿杰,于学民,李学新,林云,潘新良. 颈根部占位性病变的诊断与治疗[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 53-55.
[13] 李俏丽,李超,王薇,蔡永聪,孙荣昊,周雨秋,税春燕, 黄璐,涂静. 术后放化疗后复发并侵及侧颅底的原发性腮腺鳞状细胞癌一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 87-88.
[14] 江英,陈玥竹,饶郁芳,唐玥玓. 鼻中隔-鼻整形术矫正严重外伤性鼻畸形伴鼻中隔偏曲一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 45-47.
[15] 孙国臣,孙彦,张虹,王保为. 儿童分化型甲状腺癌的临床特征及治疗体会[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 25-28.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!