经口机器人辅助手术切除咽后甲状旁腺腺瘤：一例报告

Transoral robotic-assisted surgical excision of a retropharyngeal parathyroid adenoma: a case report.

作者信息

Bearelly Shethal, Prendes Brandon L, Wang Steven J, Glastonbury Christine, Orloff Lisa A

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California.

Department of Radiology, University of California - San Francisco, San Francisco, California.

出版信息

Head Neck. 2015 Nov;37(11):E150-2. doi: 10.1002/hed.24010. Epub 2015 Jun 29.

DOI:10.1002/hed.24010

PMID:25809987

Abstract

BACKGROUND

Transoral robotic surgery has been used with increasing frequency for oropharyngeal malignancies. We present the first known case of a transoral robotic-assisted parathyroidectomy.

METHODS/RESULTS: A 77-year-old woman with primary hyperparathyroidism was suspected of having a parathyroid adenoma. After several nonlocalizing single photon emission CT/CT sestamibi scans, a neck ultrasound revealed a suspicious low level 6 nodule. Surgical excision of this nodule proved to be a reactive lymph node. She then had a dynamic parathyroid protocol MRI and CT, which revealed a small retropharyngeal adenoma candidate. A transoral robotic-assisted surgical approach was utilized to bluntly dissect the retropharyngeal space just above the arytenoids to excise the nodule. After excision, the intraoperative parathyroid hormone (PTH) normalized and surgical pathology confirmed parathyroid adenoma.

CONCLUSION

Transoral robotic-assisted surgery is a novel technique that can be utilized for resection of a parathyroid adenoma in the retropharyngeal space.

摘要

背景

经口机器人手术在口咽恶性肿瘤中的应用频率越来越高。我们报告首例已知的经口机器人辅助甲状旁腺切除术病例。

方法/结果：一名患有原发性甲状旁腺功能亢进的77岁女性被怀疑患有甲状旁腺腺瘤。经过几次非定位单光子发射计算机断层扫描/计算机断层扫描 sestamibi 扫描后，颈部超声显示一个可疑的低回声结节。手术切除该结节后证实为反应性淋巴结。随后她进行了动态甲状旁腺方案磁共振成像和计算机断层扫描，结果显示一个可疑的咽后小腺瘤。采用经口机器人辅助手术方法，在杓状软骨上方钝性分离咽后间隙以切除结节。切除后，术中甲状旁腺激素（PTH）恢复正常，手术病理证实为甲状旁腺腺瘤。