成人口底及咽旁血管畸形的手术治疗体会及疗效观察

Surgical treatment and curative effect observation of vascular malformations in the adult floor of the mouth and pharyngeal space

目的：探讨成人口底及咽旁血管畸形的手术治疗效果。方法：对12例口底及咽旁血管畸形患者实施保留舌神经、舌下神经的血管畸形切除术。结果：术后血管病变缩小程度达Ⅳ级（优）10例,Ⅲ级（良）2例,术后无口底血肿发生。随访0.5~3年,1例术后出现伸舌偏斜,6个月后复诊伸舌居中,功能恢复;其余患者无舌肌萎缩和舌运动障碍,血管畸形未见明显复发,吞咽障碍明显减轻或消失。结论：成人口底及咽旁血管畸形采用手术切除可获得理想的治疗效果,术中保护舌神经和舌下神经及控制出血是手术成功的关键。

Objective：To investigate the effect of surgical treatment of vascular malformation in the adult floor of the mouth and pharyngeal space. Method：Collect 12 cases of vascular malformation from the floor of the mouth and pharyngeal space. All of them were checked out of the different degrees of tongue elevation and dysphagia and to carry out the excision of vascular malformation with lingual nerve and hypoglossal nerve preservation. Result： The lesion reduction degree of 10 cases of patients were IV class（excellent）, theoher 2 cases were Ⅲ class（good）. Hematoma at the bottom of the mouth after operation were not happened. Follow up 0.5--3 years, tongue devia- tion appeared in 1 cases of postoperation. After 6 months of follow-up, the tongue is in the middle when it put out, functional recovery,no tongue muscle atrophy, no tongue movement disorder in the rest of the patients, no obvious recurrence of vascular malformations, no swallowing disorder in all patients. Conclusion： It would be ob- tained ideal therapeutic effect with surgical treatment in the adult vascular malformations of the floor of the mouth and pharyngeal space. It would be the key to the success of surgery with protecting the lingual nerve and hypoglos sal nerve and controlling bleeding.