咽旁隙和颞下窝肿瘤的外科治疗进展

Advances in surgical treatment of parapharyngeal space and infratemporal fossa tumors

摘要:

咽旁隙的原发肿瘤约占头颈部肿瘤的0.5%~1%，绝大多数为良性，涎腺肿瘤和神经源性肿瘤最常见。颈侧入路和经颈-腮腺入路手术是处理咽旁隙肿瘤的主要方法。颞下窝内原发肿瘤较少，且恶性居多。该区域手术可采用颞下窝入路，上颌骨外旋入路、下颌骨外旋入路等。随着内镜辅助下经鼻、经口入路手术技术的进步和机器人手术、影像导航系统的发展，咽旁隙和颞下窝肿瘤的外科治疗呈微创化趋势。耳鼻咽喉科、头颈外科、口腔颌面外科和神经外科等相关专业的多学科合作和内镜辅助下的微创手术是该区域肿瘤外科治疗的发展方向。

Abstract:

Primary tumors of the parapharyngeal space (PPS) account for 0.5%-1% of the head and neck tumors, most of them are benign. Salivary gland tumors and neurogenic tumors are the most common. The cervical approach and the cervicalparotid approach are the main methods for the treatment of PPS tumors. There are less primary tumors in the infratemporal fossa (ITF) and most of them are malignant. For surgeries in this area, the ITF approach, the maxillary swing approach, the mandibular swing approach and other approaches can be applied. With the progress of endoscopeassisted transnasal and transoral approaches and the development of robotic surgery and image navigation system, surgical treatment of PPS and ITF tumors is minimally invasive. Multidisciplinary cooperation among the Departments of OtorhinolaryngologyHead and Neck surgery, Oral and Maxillofacial Surgery, Neurosurgery and other related disciplines, and minimally invasive surgery are the development direction of surgical treatment in this region.