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内镜辅助经口入路治疗咽旁间隙肿瘤:我们的经验及文献系统综述

Endoscopy-assisted transoral approach for parapharyngeal space tumors: Our experience and a systematic review of the literature.

作者信息

Orlando Pietro, Locatello Luca Giovanni, Gallo Oreste, Leopardi Gianluca, Maggiore Giandomenico

机构信息

Department of Otorhinolaryngology Careggi University Hospital Florence Italy.

Department of Experimental and Clinical Medicine University of Florence Florence Italy.

出版信息

World J Otorhinolaryngol Head Neck Surg. 2022 May 5;9(1):79-90. doi: 10.1002/wjo2.55. eCollection 2023 Mar.

Abstract

BACKGROUND

Several approaches have been described for the excision of parapharyngeal space tumors (PPSTs). Advances in endoscopy gave a further stimulus to the use of the transoral route.

AIMS

We present our experience with the endoscopy-assisted transoral approach (EATA) in this regard and a review of the most recent literature about EATA for PPSTs excision.

MATERIALS AND METHODS

We retrospectively analyzed our experience and systematically reviewed the literature about the outcomes of this technique.

RESULTS

Seven PPSTs were completely excised, with three of them requiring a combined transcervical approach. Only one case of postoperative wound dehiscence was registered, and the mean length of stay was 3.9 days. Final histopathological examination confirmed the results obtained with preoperative fine-needle aspiration biopsy in all cases and no recurrences were apparent after a mean follow-up of 28.1 months.

DISCUSSION

Magnetic resonance imaging, the modified Mallampati score and the 8 Ts criteria are useful instruments for the choice of the most appropriate surgical approach.

CONCLUSION

In light of our experience and following other published series in the literature, we believe that EATA may represent a safe and effective approach for the treatment of the majority of PPSTs.

摘要

背景

已经描述了几种用于切除咽旁间隙肿瘤(PPSTs)的方法。内镜技术的进步进一步推动了经口途径的应用。

目的

我们在此介绍我们在这方面使用内镜辅助经口入路(EATA)的经验,并对有关EATA切除PPSTs的最新文献进行综述。

材料与方法

我们回顾性分析了我们的经验,并系统地回顾了有关该技术结果的文献。

结果

7例PPSTs被完全切除,其中3例需要联合经颈入路。仅记录到1例术后伤口裂开,平均住院时间为3.9天。最终组织病理学检查在所有病例中均证实了术前细针穿刺活检的结果,平均随访28.1个月后未见复发。

讨论

磁共振成像、改良Mallampati评分和8 Ts标准是选择最合适手术入路的有用工具。

结论

根据我们的经验并参考文献中其他已发表的系列研究,我们认为EATA可能是治疗大多数PPSTs的一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c210/10050965/68ab01097c71/WJO2-9-79-g002.jpg

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