He Long, Xie Jinghua, Gao Xionghui
Department of Otorhinolaryngology Head and Neck Surgery,Guangzhou First People's Hospital,the Second Affiliated Hospital of South China University of Technology,Guangzhou,510180,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Sep;34(9):824-827;835. doi: 10.13201/j.issn.2096-7993.2020.09.013.
To evaluate the feasibility and safety of the endoscope-assisted transoral approach for the parapharyngeal space(PPS) tumors. This retrospective study included 22 patients who were diagnosed with PPS tumors and treated with the endoscope-assisted transoral approach. The postoperative pathological diagnosis included 10 cases of schwannoma, 7 cases of pleomorphic adenoma, 1 case of paraganglioma, 1 case of branchial cleft cyst, and 3 cases of malignant tumors for a diagnostic purpose. The surgical duration was between 15 minutes and 430 minutes(median duration 105 minutes), and the intraoperative bleeding was between 10ml to 500ml(median bleeding 20 mL). Complete resection with minor complication was performed in 21 cases, 1 case of recurrent schwannoma was done in an incomplete style because of intraoperative massive bleeding. With a 12-to-72-months follow up, there was no relapse on the 18 cases of benign tumor which were completely resected. Endoscope-assisted transoral resection provide cosmetic, micro-invasive and increased operative exposure to the PPS, especially for the benign tumors that medial to the carotid sheath. But is not recommend for relapsed cases and lesions that encompassing or lying posterolateral to the carotid sheath.
评估内镜辅助经口入路治疗咽旁间隙(PPS)肿瘤的可行性和安全性。这项回顾性研究纳入了22例被诊断为PPS肿瘤并接受内镜辅助经口入路治疗的患者。术后病理诊断包括10例神经鞘瘤、7例多形性腺瘤、1例副神经节瘤、1例鳃裂囊肿以及3例用于诊断目的的恶性肿瘤。手术时间在15分钟至430分钟之间(中位时间105分钟),术中出血量在10毫升至500毫升之间(中位出血量20毫升)。21例患者实现了完整切除且并发症轻微,1例复发性神经鞘瘤因术中大量出血而切除不完整。经过12至72个月的随访,18例完全切除的良性肿瘤无复发。内镜辅助经口切除术具有美容、微创以及增加对PPS手术暴露的优点,尤其适用于位于颈动脉鞘内侧的良性肿瘤。但不推荐用于复发病例以及累及或位于颈动脉鞘后外侧的病变。