鼻内镜辅助下经口鼻联合入路腭部巨大多形性腺瘤切除术1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2024.306

摘要/Abstract

摘要： 目的探讨腭部巨大多形性腺瘤的临床特点及个体化手术治疗方案。方法回顾性分析1例原发于腭部的巨大多形性腺瘤患者的临床资料,复习相关文献进行总结。结果腭部的多形性腺瘤一种形态复杂的上皮性肿瘤,常发生于硬腭后部与软、硬腭交界处,临床上通常表现为无症状生长缓慢的孤立性光滑肿块,有部分或完整的包膜,可引起压缩性骨质吸收。根据发病部位可引起吞咽困难、呼吸困难、咀嚼困难和鼻出血等。多形性腺瘤生长过程中有恶变的潜在危险,治疗以手术切除为主。结论对于原发于硬腭的巨大多形性腺瘤,治疗上应个体化评估制定手术方案。对于范围局限的肿瘤可采用传统的经硬腭入路,对于范围较大的肿瘤可采用内镜辅助经唇龈沟入路或内镜辅助经口鼻联合入路将肿物切除。

关键词: 腭部肿物, 硬腭, 多形性腺瘤, 鼻内镜技术

Abstract: Objective To review the clinical characteristics and individualized surgical management options for giant pleomorphic adenoma of the palate. Methods A retrospective analysis of the clinical data of a patient with a giant pleomorphic adenoma of the palate was performed and the relevant literature was reviewed and synthesized. Results Pleomorphic adenoma of the palate is a morphologically complex epithelial tumor that frequently manifests in the posterior aspect of the hard palate, at the junction with the soft palate. It typically presents clinically as an asymptomatic, slow-growing, isolated, smooth mass with partial or intact periosteum, which can result in compressive bone resorption. The tumor may cause dysphagia, dyspnea, difficulty chewing and rhinorrhea, depending on its location. The potential risk of malignancy associated with the growth process of pleomorphic adenoma necessitates a primarily surgical approach to treatment. Conclusion For giant pleomorphic adenomas originating from the hard palate, treatment should be individualized to assess and develop a surgical plan. Limited tumors can be treated with the traditional transhard-palatal approach, whereas larger tumors require the endoscopic-assisted translabiogingival sulcus approach or the endoscopic-assisted transoronasal combined approach.

Key words: Palatal mass, Hard palate, Pleomorphic adenoma, Endoscopy

中图分类号:

R736.4

孙乐,张云云,刘浩,叶京英,吴彦桥. 鼻内镜辅助下经口鼻联合入路腭部巨大多形性腺瘤切除术1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 117-122.

SUN Le, ZHANG Yunyun, LIU Hao, YE Jingying, WU Yanqiao. Endoscopic-assisted resection of giant pleomorphic adenoma in the palate via the oral and nasal approach: a case report and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 117-122.

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