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目的 探讨提高颞下窝占位性病变的诊治水平.方法 对34例颞下窝占位病变进行回顾性统计分析.结果 男性23例,女性11例.年龄为5～68岁,平均53岁.占位性病变以恶性肿瘤为主占65%,良性肿瘤及非肿瘤各占26%和9%;继发者76%,原发者21%,肿瘤远处转移至此窝者3%;颅外者91%,与颅内沟通者9%,以颌面部肿块、面痛与张口受限为主要临床表现,其中面痛及张口受限与恶性肿瘤占位呈相关关系(前者P<0.005,后者P<0.05).70%病例通过并非以发现颞下窝占位为目的的颅颌面CT或MRI检查获得诊断;仅9%以发现该窝占位病变为目的的CT检查而获诊断;6%病例出现CT假阴性;15%术前漏诊.CT或MRI正良恶性确诊率为87.5%.恶性肿瘤组二年生存率为52%.结论 掌握该窝占位病变各种临床表现及检查手段,可提高诊断水平,减少无计划性手术,可避免复发;并提高恶性肿瘤的二年生存率.
Objective To investigate the diagnosis and treatment of infratemporal fossa occupying lesions. Methods A retrospective analysis was performed on 34 cases of infratemporal fossa lesions. The results were 23 males and 11 females. The age ranged from 5 to 68 years and averaged 53 years. Occupying lesions accounted for 65% of malignant tumors, benign tumors and non-neoplasms accounted for 26% and 9% respectively; 76% of secondary tumors, 21% of primary tumors, 3% of patients with distant tumor metastasis to this nest; extracranial 91% of patients and 9% of intracranial communicators had the main clinical manifestations of maxillofacial lump, facial pain, and mouth opening limitation. There was a correlation between facial pain and mouth opening limitation and malignant tumor occupying (P < 0.005, The latter P<0.05).70% of cases were diagnosed by craniomaxillofacial CT or MRI not for the purpose of finding infratemporal fossa occupation; only 9% were diagnosed by CT for the purpose of finding the foci. 6% of cases had CT false negatives; 15% were missed before surgery. The diagnostic accuracy of benign and malignant CT or MRI was 87.5%. The two-year survival rate of malignant tumor group was 52%. Conclusions To master the various clinical manifestations and examinations of the occlusive lesions Means to improve the diagnosis, reduce unplanned surgery, to avoid recurrence; and improve the two-year survival rate of malignant tumors.