188例咽旁间隙肿瘤的回顾性分析

Retrospective analysis of 188 cases of parapharyngeal space tumors

目的:探讨咽旁间隙肿瘤的诊断、治疗、手术入路的选择及预后。方法:回顾性分析2007-01-2016-12期间收治的188例咽旁间隙肿瘤患者的临床资料。所有患者术前均行影像学检查,采用的手术入路为:经颈侧入路159例,内镜辅助经鼻入路9例,经颈-下颌骨裂开入路8例,经颈-腮腺入路8例,经口入路7例,颞下窝侧颅底入路4例。结果:术后病理良性168例(89%)、恶性20例(11%)。28例(15%)患者术后出现并发症,最常见的症状为声嘶。168例良性肿瘤随访10个月~10年,3例失访,4例术后复发,均再次手术后治愈。恶性肿瘤术后均行综合治疗,3例失访,1例术后9个月因复发死亡,其余未见复发。结论:手术切除是治疗咽旁间隙肿瘤的首选方法,术后复发率低,预后较好。内镜提供了新的手术管理方法,有利于减少手术创伤,降低并发症及复发率。

Objective：To explore the diagnosis,treatment,surgical approach and prognosis of parapharyngeal space tumors.Method：The clinical data of 188 patients with parapharyngeal space tumor who were treated from January 2007 to December 2016 were analyzed retrospectively.All patients underwent imaging examination before operation.Surgical approach was as follows：transcervical approach applied in 159 cases,endoscopic-assisted transnasal approach in 9 cases,transcervical-transmandibular approach in 8 cases,transcervical-transparotid approach in 8 cases,transoral approach in 7 cases,and infratemporal fossa approach in 4 case.Result：Of the 188 cases,the tumor was benign in nature in 168 cases（89%）and malignant in 20 cases（11%）.Complications occurred in 28（15%）patients,with the most common symptom being hoarseness.168 cases of benign tumors were followed up for 10 months to 10 years,and 3 cases were lost and 4 cases had recurrence.All cases underwent re-operation.Patients with malignant tumors received combined treatment after surgery,and 3 cases were lost to follow-up,1 case died of recurrence 9 months after surgery,the rest survived.Conclusion：Surgery is the preferred method for treating parapharyngeal space tumors and postoperative recurrence rate is pretty low.Endoscopy provides a new surgical management method,helping to reduce postoperative complications and recurrence rate.