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[颞下窝-翼腭窝-咽旁间隙肿瘤切除术手术入路的探讨]

[Investigation of the surgical approach for resecting infratemporal fossa pterygomaxillary fossa-parapharyngeal space tumor].

作者信息

Wang Yanjun, Kong Weijia, Yang Chengzhang, Liu Banghua, Yue Jianxin, Zhu Lixin, Xiong Xingao

机构信息

Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Apr;21(7):306-8.

Abstract

OBJECTIVE

To investigate the optimal surgical approach for resecting infratemporal fossa-pterygomaxillary fossa-parapharyngeal space tumor. The aim of this study is to enhance therapeutic effect and reduce complications and sequelae.

METHOD

Sixty-six patients with infratemporal fossa-pterygomaxillary fossa-parapharyngeal space tumor were analyzed retrospectively from 1998-2004, including complains, symptoms, physical signs; histodiagnosis, image examinations and surgical approaches.

RESULT

No recurrence was found in fifty benign tumor cases after 2 to 5 years, while in 16 cases with malignant tumor, four patients died in one year, 8 cases died in 2 to 4 years, and only 4 patients' survival time exceeded 4 years.

CONCLUSION

Extended maxillectomy is suitable for resecting primary carcinoma of maxillary sinus invading pterygomaxillary fossa, infratemporal fossa and /or parapharyngeal space tumor. also midface degloving approach is suitable for nasal primary cavity, nasal sinuses, nasopharynx and/or pterygomaxillary fossa tumor and localized malignant tumor. Trans-cervical combining mandibular split swing approach is suitable for parapharyngeal space tumor invading pterygomaxillary fossa and/or infratemporal fossa tumor. Trans-cervical jaw combining mandibulotomy is suitable for resecting parapharyngeal space, infratemporal fossa tumor for invading lateral skull base and pterygomaxillary fossa tumor.

摘要

目的

探讨切除颞下窝-翼腭窝-咽旁间隙肿瘤的最佳手术入路。本研究旨在提高治疗效果,减少并发症和后遗症。

方法

回顾性分析1998年至2004年66例颞下窝-翼腭窝-咽旁间隙肿瘤患者,包括主诉、症状、体征;组织诊断、影像学检查及手术入路。

结果

50例良性肿瘤患者术后2至5年无复发,而16例恶性肿瘤患者中,4例在1年内死亡,8例在2至4年内死亡,仅4例患者生存时间超过4年。

结论

扩大上颌骨切除术适用于切除侵犯翼腭窝、颞下窝和/或咽旁间隙的上颌窦原发性癌。面中部掀翻入路也适用于鼻腔原发性肿瘤、鼻窦、鼻咽和/或翼腭窝肿瘤以及局限性恶性肿瘤。经颈联合下颌骨劈开摆动入路适用于侵犯翼腭窝和/或颞下窝的咽旁间隙肿瘤。经颈颌联合下颌骨切开术适用于切除侵犯外侧颅底的咽旁间隙、颞下窝肿瘤以及翼腭窝肿瘤。

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