论文部分内容阅读
目的:探讨颈部径路咽周-颅底神经源性肿瘤的手术入路及方式。方法:将1997-2013年广东省第二人民医院采用颈颌入路和腮颈颌入路手术切除咽周-颅底神经源性肿瘤患者25例作为研究对象,对其手术入路及施术要点进行总结分析。结果:均顺利施行全切,术后病理检查显示神经鞘膜瘤23例、神经纤维瘤2例。术后随访6个月至5年,所有患者未见肿瘤复发。术中出现舌咽、迷走神经损伤4例,其中1例8个月后恢复;霍纳征1例,术后6个月恢复;舌下神经损伤2例,可能为永久性损害;腮腺漏2例。无手术死亡。结论:颈颌入路与腮颈颌入路是该区较好的手术途径,下颌骨截断对涉及颅底难以切除的肿瘤提供了较宽阔的视野。
Objective: To explore the surgical approaches and ways of neoplasia of pharynx and cranial nerves in neck pathways. Methods: Twenty-five cases of neurogenic tumors of the skull base were excised from the Second People’s Hospital of Guangdong Province between 1997 and 2013 with the approach of maxillary approach and parotid neck approach. The surgical approach and operation Summary analysis of key points. Results: All patients underwent complete resection. Postoperative pathological examination revealed 23 cases of neurofibroma and 2 cases of neurofibroma. All patients were followed up for 6 months to 5 years. No tumor recurrence was found in all patients. There were 4 cases of glossopharyngeal and vagal nerve injury in operation, of which 1 case recovered after 8 months; 1 case of Horner syndrome recovered 6 months after operation; 2 cases of hypoglossal nerve injury, which may be permanent damage; 2 cases of parotid gland leakage . No surgery died. Conclusion: Cervical jaw approach and parotid neck approach are the best surgical approaches in this area. Mandibular truncation provides a broader field of vision for tumors that are difficult to excise from the skull base.