咽旁间隙肿瘤38例临床分析

Clinical analysis of 38 cases of parapharyngeal space tumors

目的探讨咽旁间隙肿瘤的临床特征、诊断方法、病理类型、手术入路及治疗效果等。方法回顾分析本科室自2015年5月~2020年3月期间经手术干预的38例咽旁间隙肿瘤患者的临床资料。结果术后组织病理学类型丰富,主要以多形性腺瘤和神经鞘瘤占多数。手术并发症主要包括有声嘶、面瘫等。良性肿瘤患者术后无复发,恶性肿瘤患者中,1例术后3月出现肺部转移后死亡,其余患者行综合治疗后未见肿瘤复发或转移。结论咽旁间隙解剖位置深,毗邻复杂,起病隐蔽,发生于该间隙的肿瘤早期大多无特异性症状,且病理类型多样。CT和MRI是诊断咽旁间隙肿瘤的重要工具。手术切除是治疗咽旁间隙肿瘤的首选方法,完整切除率高,预后良好,在随访观察的时间内未存在复发;其中近些年来新兴的内镜辅助下切除肿瘤亦是一种新的选择,可有效减少手术创伤,降低并发症。

Objective To investigate the clinical characteristics,diagnostic methods,pathological types,surgical approaches and therapeutic effects of tumors in the parapharyngeal space.Methods To retrospectively analyze the clinical data of 38 patients with parapharyngeal space tumors who underwent surgical intervention from May 2015 to March 2020.Results Postoperative histopathological types were abundant,mainly with pleomorphic adenoma and schwannoma.Surgical complications mainly included hoarseness and facial paralysis.Patients with benign tumors had no recurrence after operation.Among patients with malignant tumors,one patient died of lung metastasis after 3 months after operation.The remaining patients did not see tumor recurrence or metastasis after comprehensive treatment.Conclusions The parapharyngeal space has a deep anatomical location,complex adjacent,and concealed onset.Most tumors occurring in this space have no specific symptoms in the early stage,and the pathological types are diverse.CT and MRI are important tools for the diagnosis of tumors in the parapharyngeal space.Surgical resection is the preferred method for the treatment of tumors in the parapharyngeal space.The complete resection rate is high,the prognosis is good,and the recurrence rate is low.Among them,the emerging endoscopic assisted tumor removal in recent years is also a new option that can effectively reduce surgical trauma and complications.