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目的:探讨涉及颅底咽旁间隙肿瘤处理的有效方法。方法:对2000年3月～2005年7月36例涉及颅底咽旁间隙肿瘤患者资料进行回顾性分析。采用的手术入路分别是:经颈侧切开入路15例,经颈-腮腺入路10例,下颌骨外旋入路4例,上颌外旋入路5例,眶颧入路2例。结果:36例肿瘤中,5例为恶性肿瘤,其余皆为良性肿瘤。31例良性肿瘤皆完整切除。5例恶性肿瘤中有2例为鼻咽黏膜下型鳞状细胞癌颅底咽旁间隙转移,经颈侧切开探查病理确诊后放射治疗,1例随诊3年无复发;1例随诊5年,复发带瘤生存;1例侵犯颅底的恶性神经纤维瘤术后3年复发,放弃治疗死亡;1例侵犯颅底的恶性神经鞘膜瘤术后已随诊3年余,健在;1例腮腺深叶黏液表皮样癌,已随诊2年余,健在。36例中,术后声嘶者3例伴呛咳1例,4例发生Horner综合征;2例发生舌偏斜,3个月后好转。结论:不同的涉及颅底咽旁间隙肿瘤有不同的临床特点,应根据各自的临床特点选择适当的处理方法。
Objective: To explore effective methods for the treatment of tumors in the parapharyngeal space of the skull base. Methods: From March 2000 to July 2005, 36 cases of patients with parapharyngeal space tumor were retrospectively analyzed. The surgical approaches were: 15 cases underwent transcranial approach, 10 cases through the neck-parotid approach, 4 cases with mandibular external rotation, 5 cases with maxillary externalization, 2 cases with orbital zygomatic approach . Results: Of the 36 tumors, 5 were malignant and the others were benign. 31 cases of benign tumors are completely removed. Two of the five cases of malignant tumors were transnasal parapharyngeal space metastases of nasopharyngeal submucous squamous cell carcinoma. Radiotherapy was confirmed by pathology after neck dissection. One case was followed up for 3 years without recurrence. One case was followed up 5 years, the recurrence of tumor-bearing survival; 1 case of malignant neurofibroma in the skull base recurrence 3 years after surgery, to give up the treatment of death; 1 case of malignant skull base tumor has been followed up more than 3 years after surgery, One case of parotid deep lobe mucoepidermoid carcinoma, has been followed up more than 2 years, alive. Thirty-six of the 36 patients had postoperative choke, 3 had cough, 1 had Hormon syndrome, 4 had tongue deformity, and 3 had postoperative improvement. CONCLUSIONS: Different tumors involving the parapharyngeal space have different clinical features and should be selected according to their respective clinical characteristics.