側咽腫瘤－57例的分析

Parapharyngeal Tumor-An Analysis of 57 Cases

呂宜興(Yi-Shing Leu) ； 張克昌(Ke-Chang Chang) ； 黃志銘(Chin-Ming Huang)

《台灣耳鼻喉頭頸外科雜誌》 38卷2期 (2003/04) Pp. 61-65

https://doi.org/10.6286/2003.38.2.61

摘要

背景：位於側咽間隙的腫瘤並不多見。側咽間隙的解剖位置複雜，臨床症狀不明顯且缺乏特性，而側咽腫瘤病理的多樣性也使得術前診斷不易，導致手術處理方式的多樣化及高困難度。
方法：馬偕紀念醫院於1989年7月至1998年6月之間收集57例側咽腫瘤，進行回溯性分析，提出報告。臨床表徵以喉頭異物感和頸部腫塊最多，所有病例皆接受手術切除。
結果：57例側咽腫瘤的病理組織中，41例屬於良性，平均年齡49.7歲（其中男性18例，平均年齡44.0歲；女性23例，平均年齡54.2歲）；16例屬於惡性，平均年齡50.3歲（其中男性9例，平均年齡54.1歲；女性7例，平均年齡45.3歲）。良性的側咽腫瘤以來自唾液線的多型性線瘤最多，其次是來自神經組織之神經瘤。惡性側咽腫瘤以來自唾液腺的最多，包括惡性混合瘤、黏液上皮癌及唾液管腺癌等，其次是來自鱗狀細胞癌轉移至側咽間隙，手術切除以經由腮腺及頸部路程最常見。
結論：側咽腫瘤雖以良性居多，但是因組織和解剖位置的複雜會造成診斷及處理方式的挑戰。

關鍵字

側咽腫瘤

並列摘要

BACKGROUND: Parapharyngeal space neoplasms are rare. The complicate anatomy at this location makes the clinical manifestation inconspicuous, hampers the correct diagnosis, and toughens the surgical approach. We report the retrospective analysis of 57 patients with parapharyngeal space neoplasms over the period of 9 years.
METHODS: Fifty-seven patients treated at the Department of Otolaryngology-Head and Neck Surgery of Mackay Memorial Hospital from 1989 to 1998 were reviewed. All patients were treated surgically. Pharyngeal lump sensation and cervical mass are the most common symptoms.
RESULTS: The histopathological results were benign in 41 cases (23 female and 18 male) with average age of 49.7. Other 16 cases (9 male and 7 female) were malignant with average age of 50.3. In the benign histopathology of parapharyngeal space tumors, pleomorphic adenoma (51.2%) was most common, followed by tumors originated from the nervous system. Malignant salivary gland tumors (68.75%) and metastatic squamous cell carcinoma (18.75%) were more common in the malignant parapharyngeal space neoplasms. The transparotid-cervical approach was most often used.
CONCLUSIONS: Most parapharyngeal space neoplasms are benign, but the variety of tumors and the complex anatomy present diagnostic and management challenges.

並列關鍵字

parapharyngeal tumor