咽旁隙神经源性肿瘤的诊治体会

The experience of diagnosis and treatment of neurogenic tumors in parapharyngeal space

目的 提高临床对咽旁隙神经源性肿瘤 (neurogenictumorsinparapharyngealspace)的诊治水平。方法 对7例手术后病例的临床资料进行回顾性分析。结果 7例咽旁隙神经源性肿瘤中 ,神经鞘膜瘤 (neurilemmoma) 4例 ,神经纤维瘤 (neurofibroma) 2例 ,神经节瘤 (ganglioneuroma) 1例。随访 3 -9年 ,7例均存活。其中 1例出现声嘶 ,1例复发。结论 咽旁隙神经源性肿瘤以神经鞘膜瘤等良性肿瘤为多 ,术后预后良好。术前仅作针刺抽吸活检 ,以减少粘连 ,便于手术分离。肿瘤应连同包膜完整摘除 ,否则易复发。手术径路的选择 :高位者 (位于鼻咽部 ) ,采用口内径路可避免切断下颌支 ,低位者 (位于口咽或喉咽部 ) 。

Objective To improve the level of diagnosis and treatment about neurogenic tumors in parapharyngeal space.Methods seven postoperative cases with neurogenic tumors in parapharyngeal space were analyzed retrospectively.Results Among the 7 cases there are 4 cases with neurilemmoma, 2 cases with neurofibroma, 1 case with ganglioneuroma. Follow up period varied from 3 to 9 years. All the seven patients survived, but one of them recrudesced and another hoarsened.Conclusions The most neurogenic tumors in parapharyngeal space is benign one. Postoperative prognosis is good. Biopsy by pumping is better than by biting because the former results in conglutination hardly thus can reduce the difficulties of surgery excision. The tumor should be full removed with their envelope or it'll recrudesce. The operation can be performed under general anesthesia. The operative approach can through the mouth which can avoid cutting off the mandible bone or lateral cervical incision,which can make the operative field in more focus.