中国眼耳鼻喉科杂志
中國眼耳鼻喉科雜誌
중국안이비후과잡지
CHINESE JOURNAL OF OPHTHALMOLOGY AND OTOLARYNGOLOGY
2014年
5期
291-295
,共5页
咽旁间隙%良性肿瘤%诊断%手术方式%并发症
嚥徬間隙%良性腫瘤%診斷%手術方式%併髮癥
인방간극%량성종류%진단%수술방식%병발증
Parapharyngeal space%Benign tumor%Diagnosis%Surgical approach%Complication
目的：探讨咽旁间隙良性肿瘤的临床特征、诊断方法、病理类型、手术径路选择及治疗效果等。方法回顾分析本科2008年1月～2014年1月期间经手术治疗的84例咽旁间隙良性肿瘤患者的临床资料。结果男性35例、女性49例；平均年龄45．39岁。均无特异性症状，多因体检或偶然发现而就诊。主要体征为咽侧壁膨隆、软腭隆起和（或）扁桃体移位44例、颈部肿物21例，其余19例未发现阳性体征，仅影像学检查显示咽旁间隙占位。术后组织病理学类型多样，主要为多形性腺瘤和神经鞘瘤。经单纯颈侧切口入路切除肿瘤77例，经口径路2例，经颈侧-腮腺入路3例，经颈侧-下颌骨裂开术2例。经一次手术完整切除83例。随访3～73个月，平均36个月，复发1例。结论咽旁间隙位置深在、隐蔽，解剖毗邻复杂，发生于该间隙的肿瘤多无特异性症状，病理类型多样。 CT和磁共振成像是诊断咽旁间隙肿瘤的重要工具。咽旁间隙良性肿瘤以单纯颈侧切口径路切除为主，一次性完整切除率高，预后良好，复发率较低。（中国眼耳鼻喉科杂志，2014，14：291-295）
目的：探討嚥徬間隙良性腫瘤的臨床特徵、診斷方法、病理類型、手術徑路選擇及治療效果等。方法迴顧分析本科2008年1月～2014年1月期間經手術治療的84例嚥徬間隙良性腫瘤患者的臨床資料。結果男性35例、女性49例；平均年齡45．39歲。均無特異性癥狀，多因體檢或偶然髮現而就診。主要體徵為嚥側壁膨隆、軟腭隆起和（或）扁桃體移位44例、頸部腫物21例，其餘19例未髮現暘性體徵，僅影像學檢查顯示嚥徬間隙佔位。術後組織病理學類型多樣，主要為多形性腺瘤和神經鞘瘤。經單純頸側切口入路切除腫瘤77例，經口徑路2例，經頸側-腮腺入路3例，經頸側-下頜骨裂開術2例。經一次手術完整切除83例。隨訪3～73箇月，平均36箇月，複髮1例。結論嚥徬間隙位置深在、隱蔽，解剖毗鄰複雜，髮生于該間隙的腫瘤多無特異性癥狀，病理類型多樣。 CT和磁共振成像是診斷嚥徬間隙腫瘤的重要工具。嚥徬間隙良性腫瘤以單純頸側切口徑路切除為主，一次性完整切除率高，預後良好，複髮率較低。（中國眼耳鼻喉科雜誌，2014，14：291-295）
목적：탐토인방간극량성종류적림상특정、진단방법、병리류형、수술경로선택급치료효과등。방법회고분석본과2008년1월～2014년1월기간경수술치료적84례인방간극량성종류환자적림상자료。결과남성35례、녀성49례；평균년령45．39세。균무특이성증상，다인체검혹우연발현이취진。주요체정위인측벽팽륭、연악륭기화（혹）편도체이위44례、경부종물21례，기여19례미발현양성체정，부영상학검사현시인방간극점위。술후조직병이학류형다양，주요위다형성선류화신경초류。경단순경측절구입로절제종류77례，경구경로2례，경경측-시선입로3례，경경측-하합골렬개술2례。경일차수술완정절제83례。수방3～73개월，평균36개월，복발1례。결론인방간극위치심재、은폐，해부비린복잡，발생우해간극적종류다무특이성증상，병리류형다양。 CT화자공진성상시진단인방간극종류적중요공구。인방간극량성종류이단순경측절구경로절제위주，일차성완정절제솔고，예후량호，복발솔교저。（중국안이비후과잡지，2014，14：291-295）
Objective To investigate the clinical characteristics , diagnostic method , pathological type , surgical approaches and the therapeutic effect of parapharyngeal space benign tumors .Methods A retrospective review was carried out on 84 patients with benign tumors in parapharyngeal space treated from January 2008 to January 2014.Results Of the 84 patients enrolled, 35 were male and 49 were female, with a median age of 45 years.The symptoms were not characteristic and the main clinical manifestation comprised of lateral pharyngeal wall swelling in 44 patients, neck mass in 21 cases but there was no any clinical symptom and sign in the remaining 19 patients.The post-operative histopathology varied and that pleomorphic adenoma and schwannoma were the main types .The simple transcervical approach alone was performed in 77 patients,the transoral approach in 2 patients, and the transcervical plus transparotid approach was applied in 3 patients.The transcervical in combination with the transmandibular approach was used in 2 patients.Eighty-three patients had been cured with one operation .The median follow-up period was 36 months and local recurrence was observed in one patient .The post-operative complications included hemorrhage in 2 cases, surgical site infection in 2 patients, vocal cord paralysis in one patient and facial paralysis in one patient .Conclusions The parapharyngeal space is a complex anatomic region .The clinical manifestations of parapharyngeal space neoplasms were nonspecific and the pathological types of which were diversified .CT and magnetic resonance imaging were essential for the diagnosis of parapharyngeal space neoplasms .Most of the parapharyngeal space tumors are benign lesions .The majority of tumors could be excised safely and completely by using the transcervical approach .The benign lesions have good therapeutic effect, with favourable prognosis.
