CAJ | 학술논문

目的探讨经茎突隔膜入路切除咽旁间隙肿瘤的方法及疗效.方法回顾性分析2005年1月至2011年1月采用经茎突隔膜入路切除的33例咽旁间隙肿瘤患者的临床资料.其中良性肿瘤28例,恶性肿瘤5例,恶性肿瘤患者术后追加根治剂量放疗.结果采用该手术入路33例咽旁间隙肿瘤均完全切除.随访13个月至7年,中位随访时间4.6年,复发3例,其中1例为软骨肉瘤手术及放化疗后3年复发,1例脊索瘤和1例腺样囊性癌术后及放疗后5年复发,其余30例未见复发.所有患者均未发生严重并发症.2例术后出现轻度口角歪斜,3个月后完全恢复；1例神经纤维瘤术后出现声嘶、呛咳,经对症治疗后好转.结论经茎突隔膜入路具有周围组织损伤小,术野暴露充分,手术并发症少,术者可驾驭性强,术式适用范围广的特点,是切除咽旁间隙肿瘤较为理想的手术入路.
목적 탐토경경돌격막입로절제인방간극종류적방법급료효.방법 회고성분석2005년1월지2011년1월채용경경돌격막입로절제적33례인방간극종류환자적림상자료.기중량성종류28례,악성종류5례,악성종류환자술후추가근치제량방료.결과 채용해수술입로33례인방간극종류균완전절제.수방13개월지7년,중위수방시간4.6년,복발3례,기중1례위연골육류수술급방화료후3년복발,1례척색류화1례선양낭성암술후급방료후5년복발,기여30례미견복발.소유환자균미발생엄중병발증.2례술후출현경도구각왜사,3개월후완전회복；1례신경섬유류술후출현성시、창해,경대증치료후호전.결론 경경돌격막입로구유주위조직손상소,술야폭로충분,수술병발증소,술자가가어성강,술식괄용범위엄적특점,시절제인방간극종류교위이상적수술입로.
Objective To evaluate the surgical technique and efficacy of the resection of parapharyngeal space neoplasm via styloid diaphragm approach.Methods Thirty-three cases underwent the resection of parapharyngeal space tumors via styloid diaphragm approach from Jan 2005 to Jan 2011 were reviewed.Of the cases,28 were with benign tumors treated by surgery alone,and 5 were malignant tumors treated by surgery plus postoperative radical radiotherapy.Results The parapharyngeal neoplasms in all cases were completely resected via styloid diaphragm approach.The postoperative follow-up ranged from 13 months to 7 years (median =4.6 years).No tumor recurrence was found in 30 cases,but 3 cases experienced tumor recurrence,including 1 chondrosarcoma (3 years after surgery and chemoradiotherapy),1 chordoma and 1 adenoid cystic carcinoma (5 years after surgery and radiotherapy).Severe postoperative complications were not observed,but 2 cases showed mild mouth askew and fully recovered after 3 months,and 1 case was complicated with hoarseness and cough symptoms that disappeared after heteropathy.Conclusion Resection of parapharyngeal neoplasms via styloid diaphragm approach is an ideal surgical technique,with well-exposed surgical field,less tissue injury,and less postoperative complication.