Olsen K D
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn. 55905.
Laryngoscope. 1994 May;104(5 Pt 2 Suppl 63):1-28. doi: 10.1288/00005537-199405000-00001.
The parapharyngeal space, an area of complex anatomic relationships, is involved in a wide variety of benign and malignant neoplasms. Because primary parapharyngeal space tumors are rare, it is difficult to obtain surgical experience in this region. This paper reviews the anatomy, presentation, evaluation, surgical approaches, and pathologic features and complications reported in managing patients with parapharyngeal space neoplasms. Two surgical procedures have been used by the author to treat 44 tumors in the parapharyngeal space. The cervical-parotid approach was used in 35 patients, and the cervical-parotid approach with midline mandibulotomy was used in 9 patients. Of the 44 tumors, 32 were benign lesions and 12 were malignant neoplasms. Forty tumors were primary parapharyngeal space tumors, and 4 cases represented isolated metastases to parapharyngeal nodes. Recurrent tumors accounted for 12 of the 44 cases. Discussion of the indications, surgical technique, and select points pertinent to using these two operative procedures is based on the operative experience gained from these 44 patients. The use of these two operations resulted in low morbidity and provided a safe, efficacious approach to the management of all parapharyngeal space neoplasms encountered.
咽旁间隙是一个解剖关系复杂的区域，涉及多种良性和恶性肿瘤。由于原发性咽旁间隙肿瘤罕见，因此很难在该区域积累手术经验。本文回顾了咽旁间隙肿瘤患者的解剖结构、临床表现、评估、手术入路以及病理特征和并发症。作者采用两种手术方法治疗了44例咽旁间隙肿瘤。35例患者采用颈腮腺入路，9例患者采用颈腮腺入路联合下颌骨中线切开术。44例肿瘤中，32例为良性病变，12例为恶性肿瘤。40例为原发性咽旁间隙肿瘤，4例为咽旁淋巴结孤立转移。复发性肿瘤占44例中的12例。基于从这44例患者获得的手术经验，讨论了使用这两种手术方法的适应证、手术技术和要点。这两种手术的应用导致了较低的发病率，并为处理所有遇到的咽旁间隙肿瘤提供了一种安全、有效的方法。
