山东大学耳鼻喉眼学报 ›› 2014, Vol. 28 ›› Issue (4): 59-61.doi: 10.6040/j.issn.1673-3770.0.2013.360

• 论著 • 上一篇    下一篇

咽旁间隙恶性肿瘤的诊断与治疗

白永, 尹兆富, 张旻, 马丽娟   

  1. 淄博市中心医院耳鼻咽喉头颈外科, 山东 淄博 255000
  • 收稿日期:2013-12-21 出版日期:2014-08-16 发布日期:2014-08-16
  • 作者简介:白永。E-mail:baiyongzb@sina.com

Diagnosis and treatment of the malignant parapharyngeal space tumors

BAI Yong, YIN Zhao-fu, ZHANG Min, MA Li-juan   

  1. Department of Otolaryngology & Head and Neck Surgery, Zibo Central Hospital, Zibo 255000, Shandong, China
  • Received:2013-12-21 Online:2014-08-16 Published:2014-08-16

摘要: 目的 探讨咽旁间隙恶性肿瘤的临床特征、诊断和治疗方法。方法 回顾性分析5例咽旁间隙恶性肿瘤患者的临床资料,均行颈部B超及CT扫描,3例行增强MRI检查;均行颈侧入路切除肿瘤,其中2例同期行同侧功能性颈淋巴结清扫术,3例术后行放射治疗;术中快速病理、术后常规病理及免疫组织化学检查,明确诊断。结果 5例中恶性神经纤维瘤1例,恶性神经鞘膜瘤1例,腮裂癌1例,未分化癌1例,滑膜肉瘤1例;术前B超、CT、增强MRI检查可以明确肿瘤的位置、大小、形态、边界及与周边结构的关系,有助于手术入路及手术方式的选择;5例术后随访,3例随访1年内无复发,1例随访3年后死亡,1例半年后失访。结论 咽旁间隙恶性肿瘤组织类型复杂多样,预后差,颈部B超、CT扫描、增强MRI检查对肿瘤的诊断有帮助,选择合适入路肿瘤切除术是首选的治疗方法,综合治疗对患者的预后很关键。

关键词: 咽旁间隙, 恶性, 诊断, 手术, 肿瘤

Abstract: Objective To study the clinical characteristics, diagnosis and treatment of the malignant parapharyngeal space tumors. Methods A retrospective study of 5 patients with primary malignant parapharyngeal space tumors treated from 2000 to 2013 was performed. All the 5 patients received B-ultrasound and CT scan, while 3 patients underwent further enhanced MRI scanning. The transcervical approach surgery was applied in 5 patients and functional neck dissection was performed in 2 patients. Postoperative radiotherapy were applied in 3 patients. Final diagnosis was reached by frozen section and pathological studies. Results There were one malignant neurofibroma, one malignant peripheral nerve sheath tumor, one branchial cleft carcinoma, one synovial sarcoma, and one undifferentiated carcinoma. Preoperative imaging studies were very important for precise tumor localization and its relation to adjacent structures. 3 patients were alive in 1-year following-up, however, 1 patient died 3 years later and 1 patients was gone half a year later after the operation. Conclusion The malignant parapharyngeal space tumors are various in histopathology. B-ultrasound, CT scan and enhanced MRI study are helpful for diagnosis. Appropriate approach is key in the surgery of parapharyngeal space tumors. Comprehensive treatment is very important to the prognosis.

Key words: Malignant tumor, Surgery, Diagnosis, Parapharyngeal space

中图分类号: 

  • R739.81
[1] Cassoni A, Terenzi V, Della Monaca M, et al. Parapharyngeal space benign tumours: Our experience[J]. J Craniomaxillofac Surg, 2014, 42(2):101-105.
[2] 桑建中, 娄卫华, 张亚民.咽旁间隙肿瘤的诊断及手术入路选择[J].临床耳鼻咽喉头颈外科杂志, 2011, 25(21):961-965.
[3] Chijiwa H, Mihoki T, Shin B, et al. Clinical study of parapharyngeal space tumours[J]. J Laryngol Otol Suppl, 2009, 123(Suppl 31):100-103.
[4] Eisele D W, Richmon J D. Contemporary evaluation and management of parapharyngeal space neoplasms[J]. J Laryngol Otol, 2013, 127(6):550-555.
[5] 刘良发, 黄德亮, 王嘉陵, 等.原发性咽旁间隙肿瘤的诊断和治疗[J].中华耳鼻咽喉头颈外科杂志, 2012, 47(1):48-52.
[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] Mushi E, Winter S. Management of an incidental malignant peripheral nerve sheath tumour in the parapharyngeal space[J]. J Laryngol Otol, 2013, 127(1):104-106.
[8] Bourget K, Joubert M, Delemazure A S, et al. Parapharyngeal tumors: management and postoperative results[J]. Rev Laryngol Otol Rhinol (Bord), 2012, 133(3):129-136.
[9] 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.
[1] 张汝祥,田昊,马有祥. 鼻内镜鼻窦手术前筛窦颅底高度的CT评估价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 75-77.
[2] 沈勤峰,沈小燕,朱荣强,蒋斐斐,郎军添. 鼻内镜下中鼻甲功能性部分切除治疗慢性鼻窦炎76例分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 82-85.
[3] 孙莎莎,臧传善,邱杰,孙彦,孙国臣,楚庆刚. 腔镜甲状腺手术的研究进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 103-109.
[4] 朱明娟,邢凯,亢泽峰,刘健. 甲状腺相关性眼病的诊断及治疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 110-113.
[5] 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.
[6] 宋晓宇, 张宇, 李成林, 宋西成. 加速康复外科理念在慢性鼻-鼻窦炎伴鼻息肉手术治疗中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 9-12.
[7] 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.
[8] 孟立新,李健,韦善文. 鼓膜微管置入术治疗中耳不张76例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 61-65.
[9] 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.
[10] 戚敏, 李红, 王倩, 涂翠芳, 杨钦泰, 徐惠清. 加速康复外科理念在功能性内镜鼻窦手术围手术期护理的初步应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 13-18.
[11] 刘大炜,张宇,李成林,陈秀梅,宋西成. 加速康复外科在儿童OSAS围手术期中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 19-22.
[12] 吴喜福, 孔维封, 王玮豪, 徐惠清, 戚敏, 杨钦泰. QoR-15在加速康复外科改善慢性鼻-鼻窦炎伴鼻息肉围手术期生活质量评估中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 5-8.
[13] 查洋,吕威,亓放,王晓巍,高志强. 上颌窦出血坏死性息肉的CT和MRI特点[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 37-42.
[14] 吕旭琴,万文锦. 阻塞性睡眠呼吸暂停低通气综合征合并高血糖患者的围手术期血糖管理[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 100-104.
[15] 魏东敏,李文明,钱晔,刘大昱,雷大鹏,潘新良. 颈侧清扫术[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 115-115.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!