内镜辅助下经口入路与口外入路切除咽旁间隙巨大良性肿瘤的效果比较

doi:10.19438/j.cjoms.2020.01.005

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (1): 28-32.doi: 10.19438/j.cjoms.2020.01.005

内镜辅助下经口入路与口外入路切除咽旁间隙巨大良性肿瘤的效果比较

林诗耿¹, 徐雄均², 陈洋¹, 李劲松^3*, 范松^3*

1.海南省人民医院·海南医学院附属海南医院口腔颌面外科,海南海口 570311;
2.中山大学附属第三医院口腔科,广东广州 510620;
3.中山大学附属孙逸仙纪念医院口腔颌面外科,广东广州 510120

收稿日期:2019-02-21 出版日期:2020-01-20 发布日期:2020-03-09
通讯作者: 李劲松,E-mail:lijs2015@yeah.net;范松,E-mail:fansong8888@163.com。^*共同通信作者
作者简介:林诗耿(1983-),男,硕士,E-mail:117551484@qq.com
基金资助:
国家自然科学基金(81460105)

Endoscopy-assisted transoral approach versus external approaches in resection of large benign parapharyngeal space tumors

LIN Shi-geng¹, XU Xiong-jun², CHEN Yang¹, LI Jin-song³, FAN Song³

1.Department of Oral and Maxillofacial Surgery, Hainan General Hospital, Affiliated Hainan Hospital of Hainan Medical University. Haikou 570311, Hainan Province;
2.Department of Stomatology, The Third Affiliated Hospital of Sun Yet-sen University. Guangzhou 510620, Guangdong Province;
3.Department of Stomatology, Sun Yat-sen Memorial Hospital, Affiliated to Sun Yat-sen University. Guangzhou 510120, Guangdong Province

Received:2019-02-21 Online:2020-01-20 Published:2020-03-09

摘要/Abstract

摘要： 目的: 比较内镜辅助下经口入路(endoscopy-assisted transoral approach,EATA)与口外入路(external approaches, EAs)2种手术方式在巨大良性咽旁间隙肿瘤(parapharyngeal space tumors, PSTs)切除术中的临床效果。方法: 将62例PST患者分为EATA组和EA组,比较2组患者围术期及术后的临床数据,采用SPSS 21.0软件包对数据进行统计学分析。结果: 所有肿瘤均完整切除。EATA组中6例患者术中转为口外入路。EA组中8例患者术中采用内镜进行辅助手术。EATA组的术中出血量、引流总量、术后疼痛评分、总住院天数均显著少于EA组(P<0.05),术后面容外形满意度评分显著高于EA组(P<0.05)。结论: 采用EATA手术方式切除咽旁间隙良性巨大肿瘤,可以减少手术创伤,获得更好的术后面容外形。然而,2种术式联合应用,可获得更好的手术效果。

关键词: 内镜, 咽旁间隙, 肿瘤

Abstract: PURPOSE: This study compared the clinical effects of endoscopy-assisted transoral approach (EATA) and external approaches (EAs) in the treatment of massive benign parapharyngeal space tumor. METHODS: Sixty-two patients with parapharyngeal space tumors(PSTs) were divided into EATA group and EA group. The perioperative and postoperative clinical data was statistically analysed using SPSS 21.0 software package. RESULTS: All tumors were completely removed. Six patients in EATA group switched to an extraoral approach during surgery. Eight patients in EA group underwent endoscopic surgery. The intraoperative blood loss, total drainage, postoperative pain score, and total length of hospital stay in EATA group were significantly less than those in EA group(P<0.05). The postoperative facial appearance satisfaction score was significantly higher in EATA group than that in EA group (P<0.05). CONCLUSIONS: Use of EATA to remove benign large tumors in the parapharyngeal space can reduce surgical trauma and obtain a better postoperative facial appearance. However, a combination of the two procedures can achieve better surgical results.

Key words: Endoscopy, Parapharyngeal space, Neoplasms

中图分类号:

R739.8

林诗耿, 徐雄均, 陈洋, 李劲松, 范松. 内镜辅助下经口入路与口外入路切除咽旁间隙巨大良性肿瘤的效果比较[J]. 中国口腔颌面外科杂志, 2020, 18(1): 28-32.

LIN Shi-geng, XU Xiong-jun, CHEN Yang, LI Jin-song, FAN Song. Endoscopy-assisted transoral approach versus external approaches in resection of large benign parapharyngeal space tumors[J]. China J Oral Maxillofac Surg, 2020, 18(1): 28-32.

参考文献

[1] Rzepakowska A, Osuch-Wójcikiewicz E, Krupa Z, et al.Surgical treatment results of parapharyngeal space tumors: a report of 22 cases[J]. Otolaryngol Pol, 2018, 72(4): 9-16.
[2] Hussain A, Ah-See KW, Shakeel M.Trans-oral resection of large parapharyngeal space tumours[J]. Eur Arch Otorh inolaryngol, 2014, 271(3): 575-582.
[3] Cassoni A, Terenzi V, Della Monaca M, et al.Parapharyngeal space benign tumours: our experience[J]. J Craniomaxillofac Surg, 2014, 42(2): 101-105.
[4] Chen WL, Wang WJ, Huang ZQ, et al.Osteotomy in the vertical ramus outside the mandibular foramen for tumours in the parapharyngeal space[J]. J Craniomaxillofac Surg, 2014, 42(3): e29-e32.
[5] Chen WL, Wang YY, Zhang DM, et al.Endoscopy-assisted transoral resection of large benign parapharyngeal space tumors[J]. Br J Oral Maxillofac Surg, 2014, 52(10): 970-973.
[6] 张大明, 陈伟良, 林钊宇, 等. 下颌下入路联合下颌支冠状劈开切除咽旁肿瘤的探讨[J]. 中国口腔颌面外科杂志, 2014, 12(3): 243-246.
[7] Fan S, Liang FY, Chen WL, et al.Minimally invasive selective neck dissection: a prospective study of endoscopically assisted dissection via a small submandibular approach in cT_1-2N₀ oral squamous cell carcinoma[J]. Ann Surg Oncol, 2014, 21(12): 3876-3881.
[8] Fan S, Chen WL, Yang ZH, et al.Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(3): 359-363.
[9] Ljichi K, Murakami S.Surgical treatment of parapharyngeal space tumors: A report of 29 cases[J]. Oncol Lett, 2017, 14(3): 3249-3254.
[10] 张强, 李龙江, 包崇云, 等. 颞下咽旁间隙原发性肿瘤临床及病理分析[J]. 实用口腔医学杂志, 2013, 29(6): 883-885.
[11] 张先锋, 曹放云, 彭正加. 内镜辅助口内入路摘除咽旁间隙肿瘤体会[J]. 中南医学科学杂志, 2016, 44(3): 350-360.
[12] Goodwin WJ Jr, Chandler JR.Transoral excision of lateral parapharyngeal space tumors presenting intraorally[J]. Laryngoscope, 1988, 98(3): 266-269.
[13] Mendelsohn AH.Transoral robotic assisted resection of the parapharyngeal space[J]. Head Neck, 2015, 37(2): 273-280.
[14] Lee HS, Kim J, Lee HJ, et al.Transoral robotic surgery for neurogenic tumors of the prestyloid parapharyngeal space[J]. Auris Nasus Larynx, 2012, 39(4): 434-437.
[15] Van Rompaey J, Suruliraj A, Carrau R, et al.Access to the parapharyngeal space: an anatomical study comparing the endoscopic and open approaches[J]. Laryngoscope, 2013, 123(10): 2378-2382.

内镜辅助下经口入路与口外入路切除咽旁间隙巨大良性肿瘤的效果比较

Endoscopy-assisted transoral approach versus external approaches in resection of large benign parapharyngeal space tumors

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	何冉, 侯德强. 口腔颌面部肿瘤患者围术期症状群与生活质量相关性研究[J]. 中国口腔颌面外科杂志, 2024, 22(5): 446-454.
[2]	黄昕, 郭正健, 包刚, 张婷婷. 牙龈软组织外周型成釉细胞瘤1例报告[J]. 中国口腔颌面外科杂志, 2024, 22(5): 510-512.
[3]	徐晨, 马丽娟, 石尧, 文玉珍, 宋永海, 车宗刚. 腮腺区炎性肌纤维母细胞瘤1例报告及文献复习[J]. 中国口腔颌面外科杂志, 2024, 22(4): 413-416.
[4]	惠琪, 高万鹏, 李欢, 赵琦, 王珺, 魏建华, 杨新杰, 杨子桧. 唾液腺腺样囊性癌微环境中肿瘤相关巨噬细胞外泌体差异表达miRNAs的筛选及验证[J]. 中国口腔颌面外科杂志, 2024, 22(3): 209-215.
[5]	王睿捷, 马海龙, 张志愿. 组蛋白乳酸化修饰在头颈肿瘤中的表达及意义[J]. 中国口腔颌面外科杂志, 2024, 22(3): 228-232.
[6]	周兴安, 白云飞, 周艳艳, 尚多, 申铁兵, 德乐黑巴特尔. 鼻内镜引导下摘除替牙期儿童上颌低位倒置埋伏牙伴囊肿1例[J]. 中国口腔颌面外科杂志, 2024, 22(3): 309-312.
[7]	陈寅瑜, 陈霖, 徐凤, 邹子川, 葛良玉, 孟箭. 过继性T细胞疗法在头颈部鳞癌中的研究进展[J]. 中国口腔颌面外科杂志, 2024, 22(2): 192-197.
[8]	任振虎，陈铭韬，吴汉江，张胜，方坤，谢尚，刘宇，胡传宇，刘冰，李春洁，朱桂全，王成，高洋，张晓晨，石剑波，张永红，崔明哲，季彤，任国欣，王延安，陈伟良，张陈平，何悦，张志愿. 头颈肿瘤围术期静脉血栓栓塞症防治中国专家共识[J]. 中国口腔颌面外科杂志, 2024, 22(1): 1-9.
[9]	王圆, 支延康. 氢吗啡酮静脉自控镇痛与皮下注射对口腔肿瘤患者术后疼痛控制效果及安全性比较[J]. 中国口腔颌面外科杂志, 2024, 22(1): 53-57.
[10]	韩林孜, 周建华, 董磊, 赵璐, 袁荣涛. 肿瘤相关成纤维细胞对口腔鳞状细胞癌生物学行为影响的研究进展[J]. 中国口腔颌面外科杂志, 2024, 22(1): 84-91.
[11]	葛良玉, 邵翠玲, 王守鹏, 陈霖, 李志萍, 顾倩平, 孟箭. 游离股前外侧皮瓣修复腮腺恶性肿瘤术后缺损12例效果评价[J]. 中国口腔颌面外科杂志, 2023, 21(6): 548-552.
[12]	靳能皓, 田瑜, 朱亮, 乔波, 李粮博, 张海钟, 张蕾. PD-L1及肿瘤免疫微环境对预测口腔鳞癌新辅助治疗效果的意义[J]. 中国口腔颌面外科杂志, 2023, 21(6): 572-578.
[13]	王钰, 王明一, 侯黎莉, 向富萍, 梁家青, 赵小妹. 口腔颌面部恶性肿瘤患者手术部位感染危险因素的meta分析[J]. 中国口腔颌面外科杂志, 2023, 21(6): 603-609.
[14]	李晨曦, 龚忠诚, 赵化荣, 丁明超, 刘慧. 肿瘤治疗电场在头颈部癌症中的应用前景[J]. 中国口腔颌面外科杂志, 2023, 21(5): 425-431.
[15]	王守鹏, 李胜男, 陈霖, 葛良玉, 李梦, 孟箭. ¹²⁵I放射性粒子植入治疗复发性腭部小唾液腺恶性肿瘤7例临床分析[J]. 中国口腔颌面外科杂志, 2023, 21(5): 497-501.