咽旁间隙肿瘤手术路径探讨(附46例分析)

Evaluation and operative approaches to tumor in parapharyngeal space:with a report of 46 cases

目的：探讨咽旁间隙肿瘤切除的最佳手术路径。方法：回顾分析咽旁间隙肿瘤的临床资料及手术路径；，46例中，11例经口咽路径，23例经颈侧路径，2例经颈侧腮腺路径，7例经颈-下颌骨正中裂开外旋路径，3例经颞下窝路径切除肿瘤。结果：43例完整切除肿瘤，3例大部切除。2例术中并发面神经损伤致不完全性周围性面瘫；2例术后出现Horner’s综合征，均于术后半月内恢复；1例术中发生大出血；术后复发3例，1例为经口咽路径切除的良性肿瘤，2例为恶性肿瘤。术后随访3～5年，2例死亡，余均健在。结论：手术切除咽旁间隙肿瘤应根据位置的不同正确选择手术路径，充分暴露术野，辨清解剖标志。

Objective： To explore the best surgical approach for parapharyngeal space tumors. Methods： The clinical data of 46 patients with parapharyngeal space tumors were restrospectively analyzed. Tumors were resected through intraoral and pharynx approach in ll patients, transcervical approach in 23, transparotid approach in 2, transcervical-transmandibular approach in 7, and infratemporal approach in 3. Results： Tumor was completely and partially resected in 43 and 3 patients, respectively. Facial nerves were injured inducing inadequate peripheral paralysis during operation in 2 patients, Homer＇s syndrome was found in 2 after operation, and massive haemorrhage happened in 1 during operation. During a follow-up of 3 to 5 years, 2 patients died, and others were still living and in good health. Conclusion： Different surgical approaches should be adopted according to the site of the tumor so as to resect the parapharyngeal space tumors totally and safely.