Liang Qin, Chi Fanglu, Zhang Xiaotong
Department of Otolaryngology, EENT Hospital, Fudan University, Shanghai, 200031, China.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2004 Jul;18(7):416-8.
To study the diagnosis, treatment and the choice of operative entrance for parapharyngeal space neoplasm.
In a retrospective study the data of 34 patients between 1993 and 2002 were analyzed with regard to presenting signs and symptoms, histological diagnosis, imaging technique and surgical approach.
88.2% of the tumors were benign. Sixteen tumors originated from salivary glands. Neurogenic tumors were found in 14 patients. Thirty-four patients were treated surgically: the trans-cervical approach was used in 26 cases, trans-oral in 5 cases, the combined transoral-cervical approach in 2 cases, and trans-infratemporal fossa in 1 case. Thirty-two tumors were removed completely. The complications after operation were Horner syndrome (3 cases), vocal cord paralysis (5 cases) and facial nerve palsy (3 cases). One patient had both vocal cord paralysis and hypoglossal nerve paralysis. With the follow-up time of 13 months to 10.5 years, 30 patients had been cured, one patient turned to better, 3 cases had recurrence local tumour (pleomorphic adenoma).
The majority of tumors can be excised safely and completely using the trans-cervical approach. Intra-oral excisions should be indicated only for small tumors that tend to pharynx with clear border.
研究咽旁间隙肿瘤的诊断、治疗及手术入路的选择。
回顾性分析1993年至2002年间34例患者的临床表现、组织学诊断、影像学检查及手术方式等资料。
88.2%的肿瘤为良性。16例肿瘤起源于涎腺。14例患者发现神经源性肿瘤。34例患者接受了手术治疗：26例行经颈入路，5例行经口入路，2例行经口-颈联合入路，1例行经颞下窝入路。32例肿瘤完全切除。术后并发症有霍纳综合征（3例）、声带麻痹（5例）和面神经麻痹（3例）。1例患者同时有声带麻痹和舌下神经麻痹。随访时间为13个月至10.5年，30例患者治愈，1例好转，3例局部肿瘤复发（多形性腺瘤）。
大多数肿瘤采用经颈入路可安全、完整切除。经口切除仅适用于边界清晰、向咽部突出的小肿瘤。
