咽旁间隙肿瘤的诊断和治疗

Diagnosis and treatment of the parapharyngeal space tumors

目的:探讨咽旁间隙肿瘤的诊断和治疗。方法:回顾性总结我院22例咽旁间隙肿瘤的诊断和治疗经验。肿瘤位于左侧者14例,右侧者8例。所有患者均接受了手术治疗,经颈侧切开肿瘤切除19例,经颈侧下颌骨裂开肿瘤切除2例,经口肿瘤切除1例。结果:术后经病理证实,神经源性肿瘤15例,腮腺深叶肿瘤4例,其他类型3例。良性肿瘤18例(81.8%),恶性肿瘤4例(18.2%)。2例恶性肿瘤患者分别于术后2年和3年因复发死亡,其余未见复发。4例行术前B超引导下穿刺活检的患者均准确区分良恶性。结论:咽旁间隙肿瘤通过病史及影像学检查可明确诊断,针吸活检有助于肿瘤性质的判定,手术是其治疗的主要手段。

Objective：To study the diagnosis and treatment of the parapharyngeal space tumors.Method：The clinical data of 22 patients with parapharyngeal space tumors treated in our hospital were retrospectively studied.All the patients underwent surgery.The tumors located in the left parapharyngeal space in 14 cases and in the right parapharyngeal space in 8 cases.Result：Different surgical approaches were used： transcervical in 19 cases,transcervical-transmandibular in 2 cases,transoral in one case.The tumors were neurogenic origin in 15 cases,salivary gland origin in 4 cases,and others in 3 cases proved by postoperative pathology.Of these,18（81.8%） were benign and 4（18.2%） malignant.Two patients with malignant tumors died 2 and 3 years respectively after operation due to recurrences,and others showed no evidence of recurrence after follow up for over one year.The fine-needle aspiration biopsy guided by ultrasonography provided the correct results of benign or malignant tumors in 4 cases.Conclusion：The image examination of the neck can identify the tumors in the parapharyngeal space.The fine-needle aspiration biopsy guided by ultrasonography can differentiate the tumor between benign and malignancy.Surgery is the mainstay treatment for tumors in the parapharyngeal space.