62例咽旁间隙肿瘤临床分析

目的：探讨咽旁间隙肿瘤的诊断和治疗方法及熟悉咽旁间隙解剖与肿瘤关系。方法：回顾性分析62例咽旁间隙肿瘤的临床资料。结果：咽旁间隙肿瘤中病理类型较多,但以神经鞘膜肿瘤比例较大,占41.9%,混合瘤22.6%,畸胎瘤、错构瘤、脊索瘤、恶性淋巴瘤及脑膜瘤等共占35.5%。进行以颈侧入路为主的4种手术入路,2例肿瘤复发（1例神经鞘膜瘤,1例转移癌）,再次手术治愈,其余均一次性手术治愈。结论：咽旁间隙肿瘤临床表现复杂,病理类型多样,肿瘤预后较好。其诊断较难,除症状体征外,CT、MRI及B超对咽旁间隙肿瘤的诊断有重要价值。手术径路是根据患者体征、影像学特征结合肿瘤位置、大小及性质而最终确定。颈侧入路为主要手术途径,气管切开为预防窒息措施。

Clinical treatment and diagnosis of parapharyngeal space neoplasms (analysis of 62 cases)

Objective:To investigate the diagnosis and treatment of parapharyngeal space neoplasms which are rarely seen clinically and close related to the anatomy of parapharyngeal space.Method:A retrospective review was carried out on 62 patients with parapharyngeal space neoplasms removal from January 1995 to December 2005.Result:Neurogenic neoplasms were the most common tumors of the parapharyngeal space neoplasms ,which constituted about 49 percent of all cases . All patients were treated successfully except 2 patients who suffered from tumor recurrence and received reoperation.Conclusion:Clinical manifestations of parapharyngeal space neoplasms were complicated and pathological types of which were diversified.Computed tomography and magnetic resonance imaging were essential for diagnosis of parapharyngeal space neoplasms. The presurgical planning was decided on the position and the pathological type of the neoplasms.