Chen Wei-liang, Wang Wei-jian, Huang Zhi-quan, Zhang Da-ming
Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Department of Oral and Maxillofacial Surgery, General Hospital of Guangzhou Military Command of PLA, Guangzhou 510100, China.
J Craniomaxillofac Surg. 2014 Apr;42(3):e29-32. doi: 10.1016/j.jcms.2013.05.008. Epub 2013 Jun 19.
Although several techniques have been described to access the parapharyngeal space, tumour surgery in this area remains a challenge. This study investigated a simple and safe technique to access parapharyngeal space tumours.
Eight primary parapharyngeal space tumours were treated with osteotomy of the vertical ramus outside the mandibular foramen. The primary tumours were pleomorphic adenoma, schwannoma, Warthin's tumour, lipoma, chordoma, and adenoid cystic carcinoma. Tumour size ranged from 4 × 4 cm to 6 × 7 cm. Patients with malignant tumours who underwent surgical resection also received adjuvant dose-fractionated stereotactic radiotherapy.
All tumours were removed completely without rupture. No patient exhibited any permanent postoperative complication, malocclusion, or other dental complications from this surgical approach. One patient had slight transient postoperative facial paresis, which resolved spontaneously within 4 weeks. The patients were followed for 7-26 months, during which no recurrence was encountered.
Osteotomy of the vertical ramus outside the mandibular foramen achieved good exposure and satisfactory aesthetic and functional results. This simple and safe technique facilitates the removal of infratemporal fossa tumours while preserving the inferior alveolar nerve.
尽管已经描述了几种进入咽旁间隙的技术，但该区域的肿瘤手术仍然是一项挑战。本研究探讨了一种简单且安全的进入咽旁间隙肿瘤的技术。
对8例原发性咽旁间隙肿瘤采用下颌孔外侧垂直支截骨术进行治疗。原发性肿瘤包括多形性腺瘤、神经鞘瘤、沃辛瘤、脂肪瘤、脊索瘤和腺样囊性癌。肿瘤大小从4×4厘米到6×7厘米不等。接受手术切除的恶性肿瘤患者还接受了辅助剂量分割立体定向放疗。
所有肿瘤均完整切除，无破裂。采用该手术方法，无患者出现任何永久性术后并发症、咬合不正或其他牙科并发症。1例患者术后出现轻微短暂性面部麻痹，4周内自行缓解。对患者进行了7至26个月的随访，期间未发现复发。
下颌孔外侧垂直支截骨术可实现良好的暴露，并获得满意的美学和功能效果。这种简单且安全的技术有助于在保留下牙槽神经的同时切除颞下窝肿瘤。
