侧颅底咽旁隙肿瘤的诊断和治疗

Diagnosis and treatment of basicranial parapharyngeal tumor

目的 探讨侧颅底咽旁间隙肿瘤的诊断和治疗。方法 分析9例侧颅底咽旁间隙肿瘤病人的临床资料。结果 手术均采用耳后颌颈联合侧进路,全切肿瘤。本组有1例术中剥断颈内动脉,出现短期对侧肢体偏瘫,无手术死亡病例。随访1～4年无复发。结论 侧颅底肿瘤以原发良性肿瘤多见,影像学检查对诊断有重要意义,但病史也不可忽视。由于位置深在,解剖结构重要、复杂,此部位肿瘤的手术切除有一定的难度和危险,术前和术中应认真考虑如何保证大脑供血,术中视野要大,采用显微手术有利于保护血管和神经。

Objective To evaluate the diagnosis and treatment of basicranial parapharyngeal tumor. Methods The clinical data of 9 basicranial parapharyngeal tumor cases were analyzed, all of which had been used the retroauricular and jaw-neck combined lateral approach. Results Tumors of all 9 cases were resected completely. The internal carotid was broken during the operation in one case and contralateral hemiplegia occurred transiently. No death happened in the operation. No recurrence was found after 1-4 year follow-up. Conclusion Basicranial parapharyngeal tumor is primarily benign tumor. Imaging examination is very important for the diagnosis but medical history can not be ignored. It is difficult and dangerous to operate on basicranial parapharyngeal tumor as its location is deep, important, and complex anatomically. How to maintain the blood supply to cerebrum must be taken into consideration before the operation. Vision must be large during the operation. Microscopes would be helpful in the protection of blood vessels and nerves.