再缝合法保留扁桃体的口内径路茎突截短术

茎突过长症并非罕见病。对症状明显者,手术是主要的治疗方法,临床上多为经口内法行茎突截短术,传统手术需常规切除扁桃体。为了保护正常扁桃体的形态和功能,我科自2006年来尝试再缝合法保留扁桃体的口内径路茎突截短术治疗茎突过长症20例（26侧）,获得成功,效果良好,现报道如下。     

94例茎突综合征临床特点及诊疗思考

目的 根据94例茎突综合征患者的临床症状、专科查体以及影像学检查判断其临床特点和术后疗效.方法 对2010年1月～2019年1月间94例茎突综合征病例回顾性分析,通过颈外进路茎突截短术、扁桃体切除术+茎突截短术、保留扁桃体茎突截短术三种手术方式,分析术后疗效.结果 94例患者茎突截去长度为25 ～61 mm,平均33 ...     

口内径路保留扁桃体的茎突截短术

目的探讨口内径路保留扁桃体茎突截短术的手术方法.方法总结10例口内径路保留扁桃体茎突截短术患者的临床特点、诊断和手术方法.结果10例患者均痊愈,术后反应轻,康复快,无并发症发生.结论口内径路保留扁桃体的茎突截短术是值得推广的手术方法.     

茎突截短术改善茎突综合征咽痛症状八例

目的 探讨茎突截短术对茎突综合征患者咽痛症状的改善情况。 方法 对8例9侧茎突综合征患者进行茎突截短术,对比分析患者手术前后临床资料。 结果 所有患者术后咽痛症状完全消失,随访7~30个月,平均20个月。1例术中切开咽上缩肌损伤小动脉致术中出血30 mL,经结扎止血;1例术后第7天发生扁桃体窝迟发性出血,经局部过氧化氢棉球压迫止血。 结论 茎突截短术可以有效改善茎突综合征患者的咽痛症状。     

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。     

经扁桃体前外侧进路内镜辅助下茎突截短术15例

目的 探讨经扁桃体前外侧进路内镜辅助下茎突截短术的方法及疗效。方法 茎突综合征患者15例, 单侧发病者 10 例, 双侧者 5 例, 均行经扁桃体前外侧进路内镜辅助下茎突截短术。结果 随访3～12个月, 治愈11例15侧, 显效3例4侧。结论 经扁桃体前外侧进路内镜辅助下茎突截短术, 具有经口进路的优点, 术中能清楚辨别周围的血管、肌肉、神经, 可以避免切除扁桃体后的并发症。本组患者疗效较好, 未发生严重不良反应。     

扁桃体切除术后茎突综合征7例

目的 探讨扁桃体切除术后出现茎突综合征的原因及茎突切除术的实施疗效。方法对 7例扁桃体切除术后茎突综合征患者行茎突切除术,并对疗效进行临床分析。结果 行单侧茎突切除术治疗6例,行双侧茎突切除术治疗1例,术后随访3个月～3年,其中症状完全消失者5例,症状明显缓解者2例。结论 扁桃体切除术后出现茎突综合征可能与局部瘢痕形成牵拉有关,手术行茎突切除是有效的治疗手段。     

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.     

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30例手术治疗临床分析

目的 探讨茎突综合征不同手术治疗方法的优势.方法 对30例茎突综合征采用不同的手术方法,其中20例扁桃体窝触诊可扪及硬性隆起者,采用切除扁桃体口内径路切除;3例舌腭弓触诊可扪及硬性隆起者,采用保留扁桃体口内径路切除术;7例咽部触诊未触及硬性隆起者,采用颈外径路切除术.结果 术后随访半年,26例咽部异物感、咽部疼痛感、耳痛、颈部下颌角部位疼痛症状消失,4例症状较术前明显减轻但未消失,无1例发生咽旁间隙感染、咽旁血肿及面神经麻痹等并发症.结论 手术截短是目前治疗茎突综合征的主要手段,临床工作中要根据茎突的长度、角度,咽部暴露情况等选择不同的手术径路,以达到最好的治疗效果.     

茎突综合症25例临床分析

目的总结分析茎突综合症的临床特点、治疗及疗效。方法回顾分析1986年1月~2004年12月我院收治的25例茎突综合症病人的临床资料、治疗及疗效。结果本组病例中单侧发病者10例,双侧者15例;咽痛前来就诊者16例,单纯咽异物感者6例,耳痛、头痛及颈部痛者各1例。所有病人均行口内径路茎突截短术。术后随访6个月以上,其中症状消失者18例(72%),症状减轻者3例(12%),症状无改善者4例(16%)。结论完整的病史、临床检查及影像学检查有助于茎突综合症的诊断。口内径路行茎突截短术是治疗该病的有效方法。     

Stylalgia and its surgical management by intra oral route -clinical experience of 332 cases

Stylalgia is a pain syndrome occurring in connection with on elongated or malpositioned styloid piocess and is more common than generally thought. 332 cases of stylalgia were diagnosed over a period of 15 years. The charcteristic symptoms were chronic throat pain during swallowing with referred otalgia or referred pain to cheek or lower part of neck associated with foreign body sensation in throat. Movements of head or act of deglutition initiates or increases the pain The diagnosis of stylalgia is based on symptoms, palpation of enlarged styloid process mtraorally in the tonsillar region and elicitation of similar nagging throat pain or pain in the neck or foreign body sensation in the throat. Confirmation of enlarged styloid process is always done by radiological examination of styloid process per orbital view. Bilateral enlargement of tyloid process were found in 196 patients (59.03%) and unilateral enlargement was found in 136 (40.96%) patients. All the patients were operated under local anaesthesia by intra oral route without any complications.     

鼻内镜在茎突过长手术中的临床应用

目的：探讨鼻内镜在茎突截短手术中的临床应用及其疗效。方法：将66例患者随机分为鼻内镜组与对照组,各组33例。鼻内镜组在茎突截短术中使用鼻内镜辅助下行茎突截短术,对照组则采用常规方法即口内路径行茎突截短术,手术均由同一术者完成。术后观察并记录茎突截短长度、手术时间、术中出血量、术后疼痛时间及程度、术后创面反应程度及术后再出血共6项指标。结果：鼻内镜组茎突截断长度较对照组长;2组手术时间比较无明显差异;鼻内镜组术中出血量为（85．0±35．0）ml,对照组为（95．0±40．0）ml,两者无明显差异;鼻内镜组患者术后疼痛较对照组轻,时间也较短;鼻内镜组患者术后创面反应较对照组轻;2组术后均无出血。结论：鼻内镜应用于双侧茎突截短术中截短茎突长度较长,且术后疼痛小,反应轻,是一种较为安全、微创的手术方式。     

茎突综合征37例临床误诊分析

目的探讨茎突综合征误诊误治相关因素及其临床疗效。方法回顾性分析37例茎突综合征的临床资料，其中包括疾病的误诊原因、诊断方法、治疗手段及治疗效果。37例患者均在气管插管全麻下手术治疗，其中28例采用经口内径路茎突部分截断术，另9例经颈外耳垂后径路茎突部分截断术。结果所有患者随访6个月至2年，痊愈32例，有效3例，无效2例。结论茎突综合征的临床症状及表现具有多样性和多变性，且此疾病与毗邻器官发病特点有相似性，容易导致误诊误治。所以充分了解和掌握茎突综合征的临床特点、必要的检查、诊断以及手术方式的选择对治疗此病非常重要。     

Tonsillectomy sparing transoral robot assisted styloidectomy

Eagle Syndrome can present with a variety of symptoms and be caused by an elongated styloid process or calcified stylohyoid ligament. Patients failing medical management of this disorder may be treated with surgical excision of the styloid process. In the literature, transoral and transcervical approach have both been described. Although transoral approaches typically begin with a tonsillectomy, tonsil-sparing approaches have also been utilized. With the advent of robotic surgery, the potential for a tonsillectomy sparing approach has become a feasible alternative, preventing the pain and morbidity associated with adult tonsillectomy while continuing to provide superior exposure and instrumentation. We report three successful cases of patients treated with tonsillectomy sparing transoral robot assisted styloidectomy. This represents the first application of this technique in the literature and suggests the potential for a paradigm shift in the surgical management of this disease.     

Is there a Relationship Between Eagle Syndrome and Cervicofacial Painful Soft Tissue Rheumatisms?

Objectives/Hypothesis: To investigate the incidence of locomotor system pathologies such as myofacial pain syndrome (MPS), fibromyalgia syndrome (FMS), and temporomandibular dysfunction in patients with Eagle Syndrome. Study Design: Prospective study. Patients and Methods: Fourteen patients with Eagle Syndrome, who were treated surgically, were enrolled in the study. Etiologic factors for cervicofacial pain were assessed, pain status was compared preoperatively and postoperatively using visual analogue scale. Palpation of tonsillar fossa, neck and shoulder examination, neurologic examination, evaluation of occlusion status, trigger points, and painful zones were done. Plain anteroposterior and lateral radiographs of the cervical spine were obtained and the lengths of the transverse processes of the seventh cervical vertebrae were measured bilaterally. Results: MPS, FMS, and temporomandibular dysfunction were diagnosed in 9 (64.3%), 3 (21.4%), and 2 (14.3%) patients, respectively. Visual analogue scale scores decreased significantly after the surgical excision of elongated styloid processes (from 6.7 ± 2.3 to 2.1 ± 1.8), and all the complaints except for headache had diminished (P < .05). Lengths of transverse processes of seventh cervical vertebra were found to be correlated with the length of styloid process (right; r = 0.644, P = .024, left; r = 0.616, P = .033). Conclusions: Cervicofacial pain is a common complaint in patients with Eagle Syndrome. It frequently coexists with rheumatic disorders resulting in chronic pain such as MPS and FMS. Even though Eagle Syndrome is a rare condition, it should be kept in mind in patients suffering from chronic cervicofacial pain that is refractory to treatment. Clinicians should be alert to diagnose and treat coexisting locomotor system disorders.     

茎突综合征114例误诊原因分析

目的 探讨茎突综合征误诊误治原因,以提高其诊治水平.方法 回顾分析114例茎突综合征的病程、误诊疾病及手术治疗效果.结果 114例患者首诊均被诊断为其他疾病.诊断为慢性咽炎、慢性扁桃体炎、舌咽神经痛77例,占总数比例为67.5%,该组病例病程相对较短,为1~6个月,中位病程为2.5个月,茎突部分截短手术有效率高,为87.0%.诊断为焦虑症、更年期综合征、神经官能症14例,该组病例病程相对较长,中位病程分别为7、2、8年,手术治疗有效率较低,为50.0%.结论 茎突综合征临床症状具有多样性、与其他疾病交叉的特点,了解掌握此病特点有助于确诊,严格掌握手术指征有助于提高手术治疗效果.