Chang Steven S, Goldenberg David, Koch Wayne M
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Ann Otol Rhinol Laryngol. 2012 Sep;121(9):620-4. doi: 10.1177/000348941212100910.
We describe our experience with the postoperative sequelae, complications, and recurrences associated with resection of a series of parapharyngeal space (PPS) tumors via a transcervical approach without submandibular gland excision, parotidectomy, or mandibulotomy.
We performed a retrospective review of 51 cases, 40 of which were pleomorphic adenomas and 11 of which were lipomas or schwannomas.
Of 30 fine-needle aspirations performed, 24 indicated pleomorphic adenoma before operation. Twenty-eight of the 30 fine-needle aspirations yielded diagnoses that were consistent with the final pathologic diagnoses. The average hospital stay was 1.05 days. After operation, there were 9 cases of trismus, 4 cases of "first bite" pain, and 7 cases of transient marginal nerve weakness. There were no recurrences over an average follow-up of 115 months.
The majority of PPS tumors are benign. It is important to use an approach that allows complete tumor excision but does not impart undue postoperative morbidity. We demonstrate that the transcervical approach without submandibular gland excision, parotidectomy, or mandibulotomy is ideal for benign PPS tumors.
我们描述了经颈部入路切除一系列咽旁间隙（PPS）肿瘤，且不进行下颌下腺切除、腮腺切除或下颌骨切开术的术后后遗症、并发症和复发情况。
我们对51例病例进行了回顾性研究，其中40例为多形性腺瘤，11例为脂肪瘤或神经鞘瘤。
在30次细针穿刺活检中，24次术前提示为多形性腺瘤。30次细针穿刺活检中有28次的诊断结果与最终病理诊断一致。平均住院时间为1.05天。术后有9例出现牙关紧闭，4例出现“第一口”疼痛，7例出现短暂的边缘神经麻痹。平均随访115个月无复发。
大多数PPS肿瘤是良性的。采用能实现肿瘤完全切除但不会带来过度术后发病率的手术方法很重要。我们证明，不进行下颌下腺切除、腮腺切除或下颌骨切开术的经颈部入路对于良性PPS肿瘤是理想的。
