Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, University Hospital Motol, V Úvalu 84, 150 06, Prague 5, Czech Republic.
Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, SE1 9RT London, UK.
Clinics (Sao Paulo). 2017 Oct;72(9):554-561. doi: 10.6061/clinics/2017(09)06.
Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa.
We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas) and one malignant tumor.
No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma) that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome.
The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.
翼腭窝解剖结构复杂，进入该区域非常困难。因此，传统上采用开放入路，但不可避免地会带来较高的发病率。为了解决这个问题，人们开发了一种经鼻内镜的入路方法，作为一种微创的手术方式。本研究的手术目的是评估经鼻内镜入路在处理翼腭窝良、恶性肿瘤中的应用价值。
我们报告了我们经鼻内镜入路治疗翼腭窝良、恶性肿瘤的经验，并总结了最近的建议。2014 年至 2016 年，我们共有 13 例患者通过经鼻内镜入路接受了翼腭窝肿块的手术治疗。该病例组包括 12 例良性肿瘤（10 例青少年鼻咽血管纤维瘤和 2 例神经鞘瘤）和 1 例恶性肿瘤。
在随访期间，没有肿瘤复发。1 例残留肿瘤（青少年鼻咽血管纤维瘤）位于海绵窦内，保持稳定。没有明显的并发症。典型的后遗症包括上颌神经感觉迟钝、牙关紧闭和干眼症。
并发症发生率低，切除效果高，支持经鼻内镜入路作为一种可行、安全、有益的治疗翼腭窝肿块的技术。
