背景:咽旁间隙是颈部的一个假想区域,从颅底延伸到舌骨的较大角。连接茎突与张量palatini的筋膜将隔室分为茎前和茎后隔室,茎前区较大。在一般人群中,咽旁区的肿瘤非常罕见,占人口中所有头颈部肿瘤的不到1%。在这个位置,CT扫描和磁共振成像(MRI)检查是免费的,应进行两种检查以检查发现的任何病变。治疗的最关键部分是全部手术切除所有癌组织。识别和治疗原发性咽旁间隙(PPS)肿瘤是头颈部癌症治疗中最具挑战性的任务之一。他们也是最具侵略性的。这项研究的主要目标是回顾我们目前在阿卜杜勒阿齐兹国王大学医院的知识,吉达,沙特阿拉伯,它是一个学术的高等教育转介中心和一个主要的教学中心。我们将专注于临床发现,肿瘤结构,肿瘤组织学分布,和手术方法。
方法:处理从两个模块开始。第一模块从从不同患者获得并收集为数据库的输入图像开始。第二个模块从通过多种不同方法进行切除的9名患者的病例系列开始:经口,经宫颈,经腮腺,经颌骨,或颞下方法。所有病例均在吉达的阿卜杜勒阿齐兹国王大学医院进行,沙特阿拉伯,2014年至2018年。所有手术干预均由耳鼻咽喉头颈外科医生进行。
结果:我们的研究包括9名患者,其中2例经腮腺入路,7例经颈及经颈/经腮腺联合入路。在我们的一例中,所面临的并发症包括血肿。
结论:当面对咽旁间隙内的多形性腺瘤时,经颈入路似乎是上级手术入路,由腮腺深叶或咽旁间隙占位性副神经节瘤引起。
BACKGROUND: The parapharyngeal space is a hypothetical region in the neck that stretches from the base of the skull to the bigger corner of the hyoid bone. The fascia that connects the styloid process to the tensor veli palatini separates the compartment into prestyloid and poststyloid compartments, with the prestyloid compartment being larger. In the general population, tumors of the parapharyngeal area are very uncommon, accounting for less than 1% of all head and neck neoplasms in the population. In this location, CT scanning and magnetic resonance imaging (MRI) exams are complimentary, and both tests should be performed to examine any lesions found. The most critical component of treatment is the total surgical removal of all the cancerous tissue. Identifying and treating primary parapharyngeal space (PPS) tumors are among the most challenging tasks in the treatment of head and neck cancer. They are also among the most aggressive ones. The primary goal of this
study is to review our current knowledge at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, which serves as an academic tertiary referral center and a major teaching center. We will focus on clinical findings, tumor structure, tumor histological distribution, and surgical approaches.
METHODS: The processing starts with two modules. The first module starts with the input images obtained from various patients and collected as a database. The second module starts with the collection of case series of nine patients undergoing excision via multiple different approaches: transoral, transcervical, transparotid, transmandibular, or infratemporal approach. All cases were conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, between 2014 and 2018. All operative interventions were performed by an otolaryngology-head and neck surgeon.
RESULTS: Our
study comprised nine patients, of which two underwent transparotid and seven transcervical and combined transcervical/transparotid approach. Complications faced included a hematoma in one of our cases.
CONCLUSIONS: The transcervical approach appeared to be the superior surgical approach when facing a pleomorphic adenoma within the parapharyngeal space, arising from the deep lobe of the parotid gland or parapharyngeal space-occupying paraganglioma.