Chen Xiaohong
Department of Thyroid and Head and Neck Surgery，Beijing Tongren Hospital，Capital Medical University，Beijing，100005，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Sep;36(9):710-714. doi: 10.13201/j.issn.2096-7993.2022.09.012.
Due to the deep location and complex anatomy of the parapharyngeal space, the exploration of improved surgical approach for tumors in the parapharyngeal space is one of the hotspots in the head and neck surgery in recent years. Transoral endoscopic approach has the advantages of small trauma and short path, which is gradually widely used in the resection of tumors in the parapharyngeal space. However, due to the limited operation space and the difficulty of tumor exposure, it is laborious to operate through transoral approach, and the risk control is rather critical. The transoral endoscopic parapterygomandibular ligament internal approach can fully expose the upper and lower poles of tumors in the parapharyngeal space, and avoid damage to the greater and lesser palatine nerve and blood vessels. This surgical approach has a satisfactory protective effect on the sensory function of oral and soft palate mucosa, as well as the tensor velum palatine muscle and levator velum palatine muscle with less surgical trauma and fewer postoperative complications.
由于咽旁间隙位置深在、解剖结构复杂，探索改进的咽旁间隙肿瘤手术入路是近年来头颈外科的热点之一。经口内镜入路具有创伤小、路径短的优点，逐渐广泛应用于咽旁间隙肿瘤的切除。然而，由于手术空间有限以及肿瘤暴露困难，经口入路操作费力，风险控制相当关键。经口内镜翼突下颌韧带内侧入路能充分暴露咽旁间隙肿瘤的上下极，避免损伤腭大、小神经及血管。该手术入路对口腔及软腭黏膜的感觉功能、腭帆张肌及腭帆提肌具有良好的保护作用，手术创伤小，术后并发症少。
