论文部分内容阅读
目的 :探讨咽旁间隙肿瘤手术并发症的预防措施。方法 :4 1例咽旁间隙肿瘤患者行手术治疗 ,经口入路 6例 ,腮腺径路 6例 ,经颈外径路切除 2 5例 ,颈外加下颌骨切断 2例 ,侧颅底径路 2例。术中气管切开 8例。4例部分切除肿瘤 ,37例完全切除肿瘤。结果 :术腔感染 2例。永久性神经损伤有 :Horner综合征 2例 ;其他神经损伤 5例 ,主要为Ⅶ、Ⅸ、Ⅹ、Ⅺ脑神经损伤。 1例巨大神经鞘瘤并发大出血。随访 11个月～ 6年 ,复发 6例 ,1例为口咽径路的良性肿瘤 ,5例为恶性肿瘤。结论 :熟悉咽旁间隙解剖 ,详细的术前评估 ,合理的手术径路和完善的术腔处理是避免并发症的重要条件。
Objective: To explore the preventive measures of surgical complications of parapharyngeal space tumor. Methods: A total of 41 patients with parapharyngeal space tumor were treated surgically. There were 6 cases of oral paraesthesia, 6 cases of parotid pathology, 25 cases of resection of external carotid pathology, 2 cases of mandibular external carotid and 2 cases of lateral skull base approach. Tracheotomy in 8 cases. Four patients underwent partial resection of the tumor and 37 had complete removal of the tumor. Results: 2 cases of intraoperative infection. Permanent nerve injury: Horner syndrome in 2 cases; other nerve injury in 5 cases, mainly Ⅶ, Ⅸ, Ⅹ, Ⅺ cranial nerve injury. One case of schwannoma complicated by massive hemorrhage. Followed up for 11 months to 6 years, 6 cases were recurred, 1 was benign tumor of the oropharyngeal path and 5 was malignant tumor. Conclusion: Familiar with the parapharyngeal space dissection, detailed preoperative assessment, reasonable surgical approach and improve the surgical treatment of the cavity is an important condition to avoid complications.