CAJ | 학술논문

目的探讨原发于咽旁较大肿瘤的手术颈侧入路及诊疗体会,进一步指导临床工作.方法回顾分析咽旁间隙肿瘤患者的,临床资料及手术路径.咽旁良性肿瘤直径>10 ca的患者中,神经鞘膜瘤12例,副神经节瘤6例,多形性腺瘤3例,2例鞘膜瘤沟通颅内外.手术采用颈侧入路、颈腮腺入路.结果 21例患者中19例完整切除,2例部分切除.1例术后出现颈静脉孔综合征,1例术后出现声音嘶哑,2例术后出现霍纳综合征.随访1～5年,无复发.结论术前行CT、MRI检查对咽旁间隙肿瘤治疗方案和手术径路的选择有重要意义.肿瘤较大并与颅底血管神经关系密切并非是颈侧入路的禁忌证.只要稍加改动也可做到安全、有效、简捷、微创,我们尝试经颈侧入路切除累及颅底血管神经区的较大肿瘤,初步结果满意.
목적 탐토원발우인방교대종류적수술경측입로급진료체회,진일보지도림상공작.방법 회고분석인방간극종류환자적,림상자료급수술로경.인방량성종류직경>10 ca적환자중,신경초막류12례,부신경절류6례,다형성선류3례,2례초막류구통로내외.수술채용경측입로、경시선입로.결과 21례환자중19례완정절제,2례부분절제.1례술후출현경정맥공종합정,1례술후출현성음시아,2례술후출현곽납종합정.수방1～5년,무복발.결론 술전행CT、MRI검사대인방간극종류치료방안화수술경로적선택유중요의의.종류교대병여로저혈관신경관계밀절병비시경측입로적금기증.지요초가개동야가주도안전、유효、간첩、미창,아문상시경경측입로절제루급로저혈관신경구적교대종류,초보결과 만의.
Objective To evaluate the cervical approach, the diagnosis and therapeutic experi-ence of primary parapharyngeal space (PPS) major tumor for further guidance of clinical work.Methods The clinical data and surgical approach of patients with PPS tumors were restrospectively analyzed.A-mong the patients with PPS tumor more than 10 cm in diameter, 12 were schwannoma,6 were ganglion and 3 were pleomorphic adenoma.2 cases of schwannoma were in both intracalvarium and outside.Trans-cervical approach and transparotid approach were applied.Rusults In 21 cases, 19 cases underwent complete resection and 2 cases underwent partial resection.Jugular foramen syndrome was acquired in 1 case after operation.Hoarse voice happened in 1 case during operation.Homer' s syndrome was found in 2 cases after operation.During a follow-up of 1 to 5 years, no recurrence.Conclusions CT and MRI before operation are valuable to the treatment and selection of surgical approach of PPS tumors.It is no contraindication for transcervical approach that tumor has an intimate relationship for basilar region,vaso-nerves area and a major volume.The transcervical approach is a simple, safe, minimal invasive and effective procedure for basilar region major tumors as long as we modified on operation slightly, and the outcome is satisfactory.