山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (2): 26-32.doi: 10.6040/j.issn.1673-3770.0.2022.066

• 论著 • 上一篇    下一篇

经口三种入路切除咽旁间隙肿瘤的应用分析

陈明浩1,张秋航2,侯佳蒙3,田秀芬1   

  1. 1.郑州大学第一附属医院 咽喉头颈外科, 河南 郑州 450052;
    2.首都医科大学宣武医院 耳鼻咽喉头颈外科, 北京 100053;
    3.郑州大学第一附属医院 放射科, 河南 郑州 450052
  • 发布日期:2023-03-30
  • 通讯作者: 田秀芬. E-mail:xiufen.tian@126.com

Clinical analysis of three endoscopy-assisted transoral approaches in the operative management of parapharyngeal space tumors

CHEN Minghao1, ZHANG Qiuhang2, HOU Jiameng3, TIAN Xiufen1   

  1. 1. Departmnt of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China;
    2. Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China;
    3. Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
  • Published:2023-03-30

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摘要： 目的 探讨在内镜及等离子辅助下经口切除咽旁间隙肿瘤(PPS)的手术入路的选择。 方法 收集耳鼻咽喉头颈外科2015年3月至2021年12月诊断为咽旁间隙肿瘤的患者56例,经口(EATA)24例,颈侧(EA)32例。统计比较临床及手术资料。 结果 所有肿瘤均完全切除,经口组分为咽后壁入路12例,咽侧壁入路7例,软腭入路5例。术后病理良性54例(96.4%),恶性2例(3.6%)。经口入路的手术时间、出血量少于颈侧组。术后颈侧组有7例出现并发症,经口组中有3例出现并发症(P=0.489)。平均随访(46.04±27.88)个月,仅经口组1例复发。 结论 根据肿瘤的大小和位置选择不同的经口入路,能提供与颈侧入路相当甚至更好的治疗效果,如在手术出血量、手术时间、无颈部瘢痕等方面,但同时也是一项具有挑战性的术式,需要更加的完善。

关键词: 咽旁间隙肿瘤, 经口入路选择, 等离子, 内镜

Abstract: Objective To investigate the transoral approaches selection factors of parapharyngeal space(PPS)tumors assisted by endoscope and low-temperature plasma radiofrequency ablation. Methods We retrospectively collected the data of 56 patients who underwent surgical removal of PPS tumors at The First Affiliated Hospital, between March 2015 and December 2021. The patients were divided into two groups based on the technique used: the endoscopr-assisted transoral approach(EATA)group(n=24)and the external approach(EA)group(n=32). Results Total tumor resection was achieved in all the cases. We designed three kinds of transoral approaches: posterior pharyngeal wall approach(n=12), lateral pharyngeal wall approach(n=7), and soft palate approach(n=5). Postoperative pathology examination confirmed benign tumors in 54(96.4%)cases and malignant tumor in 2(3.6%)cases. The operation time and the bleeding volume in the EATA group were significantly less than those in the EA group. Postoperative complications were noted in 7 cases in the EA group and in 3 cases in the EATA(P=0.489). The mean follow-up time was(46.04±27.88)months. There was only one case of recurrence in the EATA group. Conclusion The transoral approach can provide the same or even better therapeutic effect as the external approach, such as the amount of operative blood loss, operation time, no neck scars and so on, but it is also a challenging operation and needs to be improved.

Key words: Parapharyngeal space tumor, Transoral approach, Radiofrequency ablation, Endoscope

中图分类号: 

  • R739
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