茎突综合征23例临床诊治分析

目的 进一步加强对茎突综合征的认识,以减少误诊和漏诊,提高诊疗水平.方法 对2014年5月～2018年11月间收治于我院的23例茎突综合征患者的临床资料进行总结分析.结果 23例茎突综合征患者中,16例患者行单侧茎突截短术,7例行双侧茎突截短术,术后随访6～48个月,观察其术后疗效:19例患者痊愈,4例好转,2例术后结...     

内镜下经口入路保留扁桃体茎突截短术疗效分析

目的 探讨经口入路内镜辅助下保留扁桃体茎突截短术的手术方法及临床疗效.方法 回顾性分析36例(65侧)茎突综合征患者的临床资料,分析其主诉、病程、误诊情况、茎突长度、扁桃体肿大程度、手术时间、出血量、术后效果,记录患者手术前后的症状改善情况.结果 36例患者中单侧茎突过长7例,双侧茎突过长29例,共65侧茎突.其中主诉...     

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。     

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。     

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.     

以头颈部疼痛为首发症状的茎突综合征分析

目的　探讨茎突综合征患者的临床表现、手术方式及术后效果,增强耳鼻咽喉科医师对该疾病的认识。方法　回顾性分析我科2012年12月～2017年1月收治的24例以头颈部疼痛为首发症状的茎突综合征患者的手术方式,并使用视觉模拟评分法（visual analogue scale,VAS）评估患者术后效果。结果　首发症状表现为咽痛14例,颈部胀痛5例,耳痛4例,颌面部疼痛1例。茎突CT三维重建示24例患者患侧茎突长度均＞30 mm。全部患者扁桃体窝触痛阳性。18例患者经颈外入路茎突截短术,6例患者经口扁桃体切除后行茎突截短术。术后随访3～20个月,21例症状缓解,3例症状较前无改善,有效率87.5%。VAS评分术前与术后比较差异有统计学意义（t =10.112,P <0.05）。结论　以头颈部疼痛就诊的茎突综合征患者易被误诊为咽炎、外耳道炎、淋巴结炎等疾病,扁桃体窝触诊是重要的辅助手法,茎突CT三维重建具有确诊价值。诊断明确者可考虑行茎突截短术,术后效果较满意。     

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。     

经口入路低温等离子射频辅助手术治疗茎突综合征

目的:比较经口入路低温等离子射频辅助手术治疗茎突综合征与传统经口入路扁桃体切除后治疗茎突综合征两者的区别。方法:选取23例茎突综合征患者,其中13例采用经口入路低温等离子射频辅助行茎突截短,10例采用传统扁桃体切除后行茎突截短,比较2种手术方法的手术时间、术中出血量、术后疼痛评分、假膜脱落时间及疗效评价。结果:2种手术方法的手术时间、术中出血量及术后疼痛评分差异有统计学意义(P<0.01);假膜脱落时间及疗效评价差异无统计学意义(P>0.05)。低温等离子手术术后未出现迟发性出血;传统手术术后出现1例迟发性出血。结论:2种手术方法均为治疗茎突综合征的有效方式。但经口入路低温等离子射频辅助手术治疗茎突综合征具有手术时间短、术中出血少及术后疼痛轻等优点,且保留了扁桃体的形态和功能,手术简单方便,视野清楚,操作安全,符合微创理念。     

保留扁桃体口内途径茎突截短术

传统茎突截短术需要先行扁桃体切除。我科2000-2003年经口行茎突截短术48例,其中保留扁桃体经舌腭弓切口行茎突截短术15例,效果良好,报告如下。     

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.     

茎突综合征临床误诊分析

目的通过对56例茎突综合征的回顾性分析,研究该疾病的临床诊断及其误诊情况,为临床医师对该病的诊断和治疗提供参考。方法结合近年来相关文献,通过对56例茎突综合征患者的诊断及误诊资料作临床分析,对被误诊患者的临床表现、影像学检查作回顾性研究。结果56例患者中误诊为慢性咽炎23例,咽易感症16例,干燥性咽炎3例,慢性扁桃体炎9例,颈椎病2例,舌咽神经痛2例,突发性聋1例。结论详询病史,仔细专科检查,包括咽部触诊、茎突正侧位X线片或CT扫描对该病的确诊至关重要。有助于早期诊治,并减少误诊、误治。     

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。     

Elongated styloid process syndrome: intraoral versus external approach for styloid surgery

Elongated styloid process is a source of craniofacial and cervical pain. This condition is characterized by a dull, nagging, pharyngeal pain and a palpatory finding in the tonsillar fossa. Radiologic demonstration of styloid elongation is readily made in most instances. The incidence and pathogenesis of the styloid syndrome are discussed and the differential diagnosis detailed. The only effective treatment is surgical shortening of the styloid process. Eight patients undergoing surgery for elongated styloids are reported and the intraoral and external surgical approaches are presented. The external cervical approach is preferred since surgical visualization is optimal and the risk of deep cervical infection is minimal.     

Eagle syndrome: a rare and atypical pain!

The styloid process projects down and forward from the inferior surface of the petrous bone. It arises from the second branchial arch. Its average length ranges from 22 to 33 mm. The styloid process hypertrophy, or Eagle syndrome, may be a source of cervicofacial pain and is very difficult to diagnose. The pathogenesis of this abnormality is unknown. Traumatic origin is usually admitted even if recent embryological data suggest a genetic origin with interindividual variations. The diagnosis is made on several elements: exacerbated cervical pain on neck hyperextension and sudden head movements, typical pain caused by palpation of the tonsillar fossa, diagnostic test with xylocain, and radiological investigation. Treatment is surgery and exeresis of the styloid process via a transoral or cervical approach.     

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.