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经口内镜入路至茎突后外侧间隙

Endoscopic transoral approach to the lateral poststyloid space.

作者信息

Li Lifeng, Xu Hongbo, London Nyall R, Carrau Ricardo L, Jin Yonggang, Chen Xiaohong

机构信息

Department of Otolaryngology - Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

出版信息

Head Neck. 2023 Jan;45(1):294-301. doi: 10.1002/hed.27240. Epub 2022 Nov 5.

Abstract

The lateral poststyloid space (LPSS) located at the posterolateral aspect of the styloid process. This study aims to explore the anatomical relationships in LPSS via a transoral corridor, providing reference for addressing lesions extending to this region. An endoscopic transoral approach for exposure of the LPSS was performed on 6 cadaveric specimens (12 sides). Related landmarks were explored, and transoral extirpation of tumors extended into LPSS was employed in 12 patients. The deep lobe of the parotid gland, extratemporal facial nerve, and the accompanying artery in the LPSS were sufficiently exposed via the transoral corridor in all 12 cadaveric sides. The transoral corridor provided adequate exposure for tumors extending to the LPSS, and en bloc resection was achieved in these 12 patients. No facial nerve or vascular injury occurred, and no recurrence observed in this cohort with an average follow-up of 26 months. An endoscopic transoral approach provides a direct access to the LPSS. Appreciation of the anatomical relationships within the LPSS is valuable for employing a transoral extirpation of tumors extending to this specific region.

摘要

茎突外侧间隙(LPSS)位于茎突的后外侧。本研究旨在通过经口通道探索LPSS的解剖关系,为处理延伸至该区域的病变提供参考。对6具尸体标本(12侧)进行了内镜经口入路暴露LPSS的操作。探索了相关标志,并对12例肿瘤延伸至LPSS的患者采用经口肿瘤切除。在所有12侧尸体标本中,通过经口通道充分暴露了腮腺深叶、颞外面神经以及LPSS内的伴行血管。经口通道为延伸至LPSS的肿瘤提供了充分暴露,这12例患者均实现了整块切除。未发生面神经或血管损伤,该队列平均随访26个月未观察到复发。内镜经口入路可直接进入LPSS。了解LPSS内的解剖关系对于采用经口切除延伸至该特定区域的肿瘤具有重要价值。

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