茎突综合征两种手术方式的对比研究

目的：探讨茎突综合征的诊断及两种手术方式的的疗效比较。方法：可随访病例14例15侧,左侧8例,右侧5例,双侧1例,可在扁桃体窝后触摸到骨刺样物10例,不能触到的4例。均据临床症状及X线或CT扫描证实茎突过长而确诊为茎突综合征;主要症状有咽部疼痛、咽部异物感、转颈或低颌时异物感变明显、失眠等。手术方式,①口咽径路：1例在气管插管下全麻,5例局麻;截出茎突最长3.2cm,最短1.0cm,平均2.0cm。②颈外径路：1例在气管插管下全麻,7例局麻;截出茎突最长3.6cm,最短1.6cm,平均2.4cm。结果：两种手术方式患者相关症状均能渐进性消失,但术后患者在局部疼痛、讲话、吞咽、发热、手术时间的对比上具有显著差异性。结论：茎突综合征两种手术方式均具有较好的疗效,但术后患者在局部疼痛、讲话、吞咽、截出茎突长度、手术时间、出血量、住院费用、并发症的发生率的对比上,颈外径路茎突截短术更具有优势。

Two types of operations on elongation of styloid process

Objective：To investigate the styloid process syndrome in the diagnosis and the efficacy of two surgical methods of comparison.Methods：The cases of 14 cases could be followed up for 15 sides,the left side in 8 cases,the right side in 5 cases,bilateral in 1 case,tonsillar fossa in touch after the spur-like material in 10 cases,4 cases can not be touched.According to the clinical symptoms were X ray or CT scan,and confirmed the diagnosis of styloid process syndrome;the main symptoms of throat pain,foreign body sensation in the throat,when turning neck or lower jaw become apparent foreign body sensation,and insomnia.Surgical approach,①oropharyngeal pathway：1 case under intubation anesthesia,local anesthesia in 5 cases;cut the styloid longest 3.2 cm,the shortest 1.0 cm,an average of 2.0 cm.②neck external approach：1 patient under general anesthesia during tracheal intubation,7 cases of local anesthesia;cut out of the styloid process up to 3.6 cm,the shortest 1.6 cm,an average of 2.4 cm.Results：Both surgical patients progressive symptoms could disappear,but local pain in postoperative patients,speech,swallowing,fever,operative time compared to the previous significant difference.Conclusion：The styloid process syndrome in two surgical procedures all have a good effect,but local pain in postoperative patients,speech,swallowing,cut the length of the styloid process,operation time,blood loss,hospital costs,the incidence of complications contrast,the neck surgery truncated styloid external approach has more advantages.