改良舌腭弓L形切口治疗茎突过长综合征临床体会

Clinical experience in treatment with Eagle’s syndrome through improved L-shape incision of palatoglossal arch

目的探讨茎突过长综合征的诊断、改良舌腭弓L形切口手术治疗方法及术后疗效。方法回顾性分析16例采用改良舌腭弓L形切口手术治疗茎突过长患者的临床资料,分析其病史、临床症状、诊疗经过、影像学检查,随访观察手术效果并对患者术前术后疼痛情况进行VAS评分记录。结果16例采用改良L形舌腭弓切口的患者术后患侧茎突长度平均为(2.17±0.52)cm,均无创口开裂、感染、出血等并发症;在术后至少6个月随访中,87.5%(14/16)患者症状完全消失,12.5%(2/16)患者症状明显缓解;术后VAS疼痛评分(0.38±0.62)分较术前(3.94±0.68)分有明显降低(P<0.05)。结论茎突过长综合征在临床诊断上易误诊,通过扁桃体窝扪诊以及影像学检查可有效提高确诊率,基于手术使用改良舌腭弓L形切口在保留扁桃体的同时可以有效截短,且患者术后疗效满意,在短期内随访未发现其他手术并发症,此法对于临床治疗茎突过长综合征有一定指导意义。

Objective To explore the diagnosis of Eagle’s syndrome,the surgical treatment with the improved L-shape incision of palatoglossal arch and the effect after operation.Methods Retrospective analysis of the clinical materials of 16 patients with Eagle’s syndrome who underwent surgical treatment with L shape incision of palatoglossal arch was performed.The medical history,clinical symptoms,treatment history,radiological examination were analyzed,the surgical effects were followed up and preoperative and postoperative VAS pain scores were evaluated.Results The average length of the affected styloid process was(2.17±0.52)cm after surgical treatment through improved L-shape incision of palatoglossal arch.There were no local complications such as wound dehiscence,infection and bleeding after operation.Among the 16 patients,there were 14 patients whose clinical symptoms had completely disappeared and 2 patients whose symptoms had been alleviated after operation and followed up for more than 6 months.The VAS pain score after operation was 0.38±0.62 significantly lower than that of pre-operation 3.94±0.68(P<0.05).Conclusion Eagle’s syndrome can be easily misdiagnosed in clinic.Palpation of the tonsillar fossa and imageological examination can improve the diagnosis rate.The improved L-shape incision of palatoglossal arch can be employed for the patient with Eagle’s syndrome to remove the long styloid process and reserve the tonsil effectively at the same time.Also,the patients are satisfied with the post-operative effects,and no other complications are found during shot-term follow-up.This method is of some certain guidance for the clinical treatment of Eagle’s syndrome.