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目的 :探讨咽旁间隙肿瘤的诊断、治疗和手术入路的选择。方法 :回顾性分析接受手术治疗的 34例咽旁间隙肿瘤患者的临床资料 ,包括症状、体征、组织学诊断、影像学检查和手术进路。结果 :88.2 %肿瘤为良性。16例起源于腮腺 ,神经源性肿瘤 14例。颈侧进路 2 6例 ;经口腔进路 5例 ,颈侧及口咽联合进路 2例 ;颞下窝入路1例。 32例完全切除肿瘤。术后并发Horner综合征 3例 ,声带麻痹 5例 ,面瘫 3例。术侧声带和舌下神经同时麻痹 1例。随访 13个月～ 10 .5年 ,34例中 30例治愈 ,1例好转 ,术后复发 3例 (均为多形性腺瘤 )。结论 :采用颈侧进路 ,能安全彻底切除咽旁间隙肿瘤 ,经口腔进路仅适合于肿瘤边界清楚、组织明显突出于咽侧且表浅局限者
Objective: To explore the diagnosis, treatment and choice of surgical approach for parapharyngeal space tumor. Methods: The clinical data of 34 patients with parapharyngeal space tumors undergoing surgery were retrospectively analyzed. The symptoms, signs, histological diagnosis, imaging examination and surgical approach were included. Results: 88.2% of the tumors were benign. 16 cases originated in the parotid gland, neurogenic tumors in 14 cases. Neck approach 26 cases; 5 cases of oral approach, neck and oropharyngeal joint approach in 2 cases; infratemporal fossa approach in 1 case. 32 cases of complete tumor removal. Postoperative Horner syndrome in 3 cases, vocal cord paralysis in 5 cases, 3 cases of facial paralysis. One case had paralysis of both vocal cord and hypoglossal nerve at the same time. Followed up for 13 months to 10.5 years, 30 cases of 34 cases were cured, 1 case improved, 3 cases of recurrence (all pleomorphic adenoma). Conclusion: The approach of the neck side can safely and completely remove the parapharyngeal space tumor. The oral approach is only suitable for the clear border of the tumor, the tissue is obviously prominent in the pharynx and the superficial