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目的分析肿瘤主体位于翼腭窝的临床表现,探讨其手术方法及其疗效。方法回顾分析7例以翼腭窝为主要病变区域的肿瘤性疾病的诊治经过,其中原发性肿瘤3例,分别为纤维组织细胞瘤、神经纤维瘤和胆脂瘤,继发性肿瘤4例,其中上皮肌上皮癌、腺样囊性癌各1例,鼻内翻性乳头状瘤和恶性组织细胞瘤外院术后复发各1例。神经纤维瘤和胆脂瘤患者分别行内镜辅助下鼻腔上颌窦或口腔上颌窦径路,纤维组织细胞瘤患者及4例继发性肿瘤者采用鼻侧切开径路。结果腺样囊性癌患者术后4个月局部复发,激光扩大切除后随访3年无复发或转移,其余6例患者术后1个月～3个月术腔上皮化,随访2～4年无复发或转移。主要并发症为鼻口腔瘘2例,愈合时间分别为术后9个月和11个月,鼻咽反流和下眼睑水肿各1例,分别于术后1个月和3个月消失。结论CT或MRI是诊断翼腭窝肿瘤的主要方法,经鼻腔上颌窦、口腔上颌窦或鼻侧切开径路可有效切除该处肿瘤。
Objective To analyze the clinical manifestations of the main tumor located in the pterygopalatine fossa and to explore its surgical method and its curative effect. Methods A retrospective analysis of 7 cases with pterygopalatine foci as the main lesion in the diagnosis and treatment of tumor disease, including 3 cases of primary tumors were fibrohistiocytoma, neurofibromatosis and cholesteatoma, secondary tumor in 4 cases , 1 case of epithelial myoepithelial carcinoma, adenoid cystic carcinoma, 1 case of recurrent nasal inverted papilloma and malignant histiocytoma outside the hospital. Patients with neurofibromatosis and cholesteatoma underwent endoscopic nasolacrimal incision guided by nasal sinus or oral maxillary sinus pathways, patients with fibrous histiocytoma, and 4 patients with secondary tumors. Results The patients with adenoid cystic carcinoma had local recurrence 4 months after operation. No recurrence or metastasis was observed after 3 years of follow-up after laser expansive resection. The remaining 6 patients had epithelialized cavities 1 to 3 months after operation, followed up for 2 to 4 years No recurrence or metastasis. The main complication was nasal fistula in 2 cases, the healing time was 9 months and 11 months after surgery, nasopharyngeal reflux and lower eyelid edema in 1 case, respectively, after 1 month and 3 months disappeared. Conclusion CT or MRI is the main method to diagnose the tumors in the pterygopalatine fossa. The maxillary sinus, oral maxillary sinus or nasal lateral incision can effectively remove the tumor.