手术治疗茎突过长116例临床观察

茎突过长引起咽痛、咽异物感在临床上颇为常见。 1 983～ 1 999年我们对经Ｘ线摄片诊断为茎突过长的 1 1 6例患者施以部分茎突截短术 ,经观察效果满意。现对其临床资料进行分析 ,现报告如下。1　资料与方法1 .1 　 临床资料1 1 6例患者 ,女 83例 ,男 33例 ;年龄 2 1～ 63岁 ,平均 46岁。均有不同程度的咽痛、头颈痛、咽异物感 (包括咽部牵拉感、紧迫感、梗阻感等 )及反射性耳痛等多种症状。检查 :咽局部及全身无其它病变。行后前位Ｘ线摄片 ,并在Ｘ线片上测量茎突长度 ,茎突长于 3.0ｃｍ诊断为茎突过长。茎突平均长度左侧 4.30ｃｍ、右侧 4.…     

茎突综合征72例分析

目的:探讨茎突综合征的正确诊断方法。方法:对疑有下颌角区异物感、咽部疼痛感、牵拉感、扁桃体术后伤口未愈合感等患者行茎突CT扫描及CT三维重建,确诊为茎突过长263例,其中72例行扁桃体切除加茎突截短术(59例行茎突截短术,13例行梳理术)。结果:术后随访,72例患者术前症状全部消失。结论:CT扫描及三维重建对诊断茎突过长综合征准确、可靠。     

茎突舌骨韧带骨化的临床诊治

目的 探讨茎突形态异常茎突舌骨韧带骨化患者的临床特点和手术方法.方法 对9例茎突舌骨韧带骨化者术前行茎突的CT扫描并行三维重建以明确诊断.采用颈外径路茎突截短术,术中截除骨化的茎突舌骨韧带、舌骨小角及部分茎突.结果 9例患者中8例临床症状消失,1例症状较前明显减轻,无明显并发症. 结论 对于茎突过长的特殊类型茎突舌骨韧带骨化者行茎突CT扫描可明确诊断,行颈外径路茎突截短术,临床疗效确切,患者无明显不良反应.     

茎突综合征174例报告

茎突综合征是因茎突过长、或其方位、形态异常致与邻近血管、神经相抵触所引起的咽部异物感，咽痛及反射性耳痛、头痛、颈痛等症状的总称。１９８６年２月～１９９９年６月我们手术治疗１７４例。现报告如下。１资料与方法１．１　临床资料 １７４例中，男８６例，女８８例；年龄最小２１岁，最大６９岁。病程５月～１３年；单侧５２例，双侧１２２例；扁桃体摘除术后１０例。Ｘ线摄片显示茎突最长约５．８ｃｍ，最短约２．５ｃｍ。扁桃体窝内能触及１６６例，不能触及８例。茎突形态细长圆锥形１０３例，结节型６９例，分节型２例。咽异物…     

茎突综合征的诊断方法探讨

茎突综合征是因茎突过长或方位、形态异常，导致与邻近血管、神经、肌肉等相抵触，引起咽喉痛、咽异物感，颌下、颈侧、枕顶、耳部、头面、肩背等部位不适，或疼痛等症状的总称，是耳鼻喉科常见病之一，占我们两院耳鼻喉科门诊病人的１／１２５。此综合征症状较复杂，易与...     

多层螺旋CT多平面和三维重建技术诊断茎突过长症30例

目的 探讨多层螺旋CT（multi-slice computed tomography,MSCT）对茎突过长症的诊断价值.方法 对30例临床疑为茎突过长症但X线平片显示不清的患者,行茎突MSCT横断面螺旋方式扫描及多平面重建（multiplanar reformation,MPR）,并利用容积漫游技术（volume rendering technique,VRT）对茎突进行三维重建.结果 30例患者均得到确诊.通过MPR图像准确测得茎突长度,单侧过长23例,双侧过长7例.VRT图像可直观、立体的显示茎突的长度和角度,并可通过旋转多方位观察茎突的形态和解剖位置.结论 茎突MSCT轴位扫描结合MPR、VRT技术对茎突过长症诊断有重要价值.     

茎突过长的CT诊断

茎突综合征是指茎突过长或舌骨韧带骨化引起的临床症状,有咽喉痛、吞咽痛、咽喉异物感、颈部转头不适或有耳痛、肩背疼痛等综合症状.以往靠X线摄片作为辅助检查诊断.但因投照模糊不清,茎突难以辨认.应用CT扫描,茎突显示非常清晰.现报告如下.     

茎突异常与茎突综合征的关系

<正>茎突异常即茎突的长度、方位、形态异常等,茎突异常刺激了邻近的黏膜、肌肉、血管、神经等引发的咽部异物感、咽部疼痛、咽部刺痒、咳嗽、颈痛、头痛、头昏、耳鸣等系列症状,称为茎突综合征[1-2]。近年来,国内外专家学者进行了解剖和临床的研究探讨,观察了茎突异常与周围结构之间的互相刺激和影响而引发的一系列临床症状,加深了对茎突综合征的认识,为临床诊断和原因探讨提供了解剖和临床的资料[3-5]。     

茎突综合征64例

茎突综合征是由于茎突过长或其方位、形态异常 ,触及邻近的主要血管及神经所引起的咽部异物感、咽痛、头颈痛等症候群。该综合征表现复杂 ,常被误诊误治。现将我院 1 991年以来CT三维重建64例茎突综合征患者报告如下。1　临床资料64例中 ,男 5 2例 ,女 1 2例 ;年龄 34～ 68岁 ,平均 5 1岁。主诉 :咽痛 2 5例 ,咽喉异物感 1 6例 ,吞咽痛或梗阻不适感 8例 ,放射性颈痛 5例 ,耳痛及耳闷胀感 4例 ,胸痛 3例 ,舌根痛 3例。检查 :64例中有 60例较为明显 ,患侧扁桃体窝可明显触及索状物或骨刺状物 ,CT三维重建茎突长度 :右侧 2 .4～ 6.5cm ,平均 …     

螺旋CT三维重建在茎突过长诊断中的应用

目的 :寻找一种诊断茎突过长症的有效方法。方法 :采用螺旋CT三维重建测量。结果 :2 0例怀疑茎突过长症的患者 ,均通过螺旋CT三维重建确诊。结论 :螺旋CT三维重建对茎突过长症的诊断有重要作用 ,在有条件的医院值得推广使用     

茎突截短术的并发症

目的：探讨在治疗茎突过长症中不同手术方奉的并发症及预防措施。方法：146例茎交过长症患者采用口咽径路54例，颈外径路92例行茎突截短术。结果：采用口咽径路的54例中，手术成功率为92．6％，并发症发生率为7．4％，有效率为83．3％；采用颈外径路的92例中，手术成功率为98．9％（P〈0．05），并发症发生率为7．6％（P〉0．05），有效率为94．6％（P〈0．05）。结论：茎突过长症不同的手术方式各有优缺点。颈外径路手术效果优于口咽径路。     

The syndrome of elongated styloid process

Symptom-complex associated with the elongated styloid process is more common than generally thought. The exact etiology of this syndrome has not yet been fully understood. The present article is a review of the symptoms, physical signs, theories of causation, diagnosis and treatment of this condition. During the 20 years period from 1975 to 1995, 35 symptomatic patients with the established diagnosis of elongated styloid process were managed. Their diagnosis were confirmed by clinical and radiological examinations. Surgical shortening of the elongated processes were done by intraoral transtonsillar approach under general anaesthesia. Twenty were bilateral and 15 were unilateral elongations. Eighteen were males and seventeen were females. Largest distribution of patients in age was seen in the fifth decade of life. Pain in the throat was most frequently encountered as the presenting complaint. A total of 31 patients obtained complete symptomatic relief within 6 months following operation. In four patients there were either incomplete relief or recurrence of symptoms after operations. Elongated styloid process may be one of the causes annoying maxillofacial or craniocervical pain. It requires thorough clinical examination of the head and neck, and should be confirmed radiologically. Occasionally multidisciplinary cooperation may be needed to come to a diagnosis. Surgical shortening of the elongated process is the only way to give symptomatic relief to the patient. Further research is needed to understand the aetiogenesis of this condition.     

茎突综合征的手术总结

目的探讨茎突综合征手术类型及命名。方法对我院192例328侧茎突手术进行了回顾性分析。根据茎突手术的过程不同,进行归纳,并对比其临床效果。结果本组病例在茎突手术时发生四种情况:茎突切除术,茎突缩短术,茎突折断术和茎突梳理术,其临床效果无显著差异。结论将茎突手术规范成四种类型,具有临床实用意义。     

Unusual sinus of the styloid process

 The case of a 50-year-old man with an unusual sinus of the styloid process is presented. This anomaly caused recurrent otorrhea and repeated neck inflammation. The sinus was identified in the upper part of the styloid process and was resected completely as definitive treatment. Since the styloid process is formed by mesenchymal tissue of the second branchial arch, lack of chondrification and ossification was presumed to be the cause of the sinus found in the patient. In case of direct communication between the styloid process cavity and the middle ear space the term “styloid process recess” is suggested. This recess can act as a possible source for recurrent middle ear infections and neck inflammations. Received: 11 March 1998 / Accepted: 21 April 1998