累及咽旁间隙不同类型肿瘤的手术入路及下颌骨处理策略分析

Analysis of surgical approaches and mandibular treatment strategies for different types of tumors involving parapharyngeal space

累及咽旁间隙肿瘤的手术具有复杂性,为探讨累及咽旁间隙不同特征肿瘤的外科策略,本研究纳入2015年1月至2021年1月就诊于山西医科大学第一医院口腔颌面外科累及咽旁间隙肿瘤患者,分析患者疾病资料,总结其手术入路和下颌骨处理方式,探讨累及咽旁间隙不同特征肿瘤的外科策略。研究共纳入患者49例,其中男性28例,女性21例,中位年龄52岁(24~72岁)。分别使用4种手术入路切除肿瘤,包括颈侧入路25例、颈颌入路16例、腮颈入路5例和经口入路3例。颈颌入路的患者中,3例采用下颌骨方块切除,6例采用下颌骨暂时性离断,7例采用肿瘤连同部分下颌骨切除的方法完成手术。累及咽旁间隙肿瘤的手术入路及下颌骨处理方式多样,临床上需综合肿瘤最大径、位置、边界、血供及病理类型等多种因素进行决策。

In view of the surgical complexity of parapharyngeal space tumors involved,this paper summarized the disease data of patients with parapharyngeal space tumors involved in the Department of Oral and Maxillofacial Surgery,the First Hospital of Shanxi Medical University from January 2015 to January 2021.It also summarized the surgical approach and mandibular management,so as to explore surgical strategies for different characteristics of parapharyngeal space tumors involved.A total of 49 patients,including 28 males and 21 females,median age 52 years(range 24-72 years).They were treated with four surgical approaches for tumor resection,25 cervical approach,5 cheek and neck approach,3 transoral approach,and 16 cervical-maxillary approach.Among the patients treated with cervical-maxillary approach,3 patients were treated with mandible square resection,and 6 patients were treated with temporary mandible dissection.Seven cases were treated with tumor resection and partial mandibular resection.There are various surgical approaches and mandibular management methods involving tumors in the parapharyngeal space,and clinical decisions should be made based on tumor diameter,location,boundary,blood supply and pathological types.