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摘要: 咽旁间隙是头颈部复杂的筋膜间隙,其内包含血管、神经等重要解剖结构。发生于咽旁间隙的肿瘤少见,以良性病变为主,手术是主要治疗方法。由于解剖结构复杂,咽旁间隙肿瘤手术具有挑战性。传统咽旁间隙肿瘤手术以开放入路为主,手术创伤大、术后并发症发生率高。随着解剖研究的深入和手术技术的发展,近年咽旁间隙解剖和手术入路研究取得一定进展,本文将围绕这一主题进行综述。Abstract: The parapharyngeal space, a complex fascial compartment within the head and neck region, encompasses crucial anatomical structures including blood vessels and nerves. Tumors occurring within this space are rare, with the majority being benign in nature. Surgical intervention remains the primary treatment modality; however, managing parapharyngeal space tumors poses significant challenges due to their intricate anatomical configuration. Conventional open surgical approaches have been associated with significant tissue damage and a high prevalence of postoperative complications. Recently, advancements in anatomical studies and surgical techniques have led to significant progress in understanding parapharyngeal space anatomy and improving surgical management. This article aims to provide a comprehensive overview of these developments.
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Key words:
- parapharyngeal space /
- endoscope /
- transoral approach /
- internal carotid artery
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[1] Sun X, Yan B, Truong HQ, et al. A Comparative Analysis of Endoscopic-Assisted Transoral and Transnasal Approaches to Parapharyngeal Space: A Cadaveric Study[J]. J Neurol Surg B Skull Base, 2018, 79(3): 229-240. doi: 10.1055/s-0037-1606551
[2] Maheshwar AA, Kim EY, Pensak ML, et al. Roof of the parapharyngeal space: defining its boundaries and clinical implications[J]. Ann Otol Rhinol Laryngol, 2004, 113(4): 283-288. doi: 10.1177/000348940411300405
[3] Riffat F, Dwivedi RC, Palme C, et al. A systematic review of 1143 parapharyngeal space tumors reported over 20 years[J]. Oral Oncol, 2014, 50(5): 421-430. doi: 10.1016/j.oraloncology.2014.02.007
[4] Kuet ML, Kasbekar AV, Masterson L, et al. Management of tumors arising from the parapharyngeal space: A systematic review of 1, 293 cases reported over 25 years[J]. Laryngoscope, 2015, 125(6): 1372-1381. doi: 10.1002/lary.25077
[5] Liu J, Liu Q, Sun XC, et al. Endoscopic transoral approach to the parapharyngeal space: technical nuances and preliminary results[J]. J Laryngol Otol, 2023, 137(6): 678-684. doi: 10.1017/S0022215122001621
[6] Li L, London NR Jr, Gao Y, et al. Endoscopic transoral approach for resection of retrostyloid parapharyngeal space tumors: Retrospective analysis of 16 patients[J]. Head Neck, 2020, 42(12): 3531-3537. doi: 10.1002/hed.26415
[7] Joo W, Funaki T, Yoshioka F, et al. Microsurgical anatomy of the infratemporal fossa[J]. Clin Anat, 2013, 26(4): 455-469. doi: 10.1002/ca.22202
[8] Guidera AK, Dawes PJ, Fong A, et al. Head and neck fascia and compartments: no space for spaces[J]. Head Neck, 2014, 36(7): 1058-1068. doi: 10.1002/hed.23442
[9] Peter M. SOM H D C. Head and Neck Imaging[M]. 5 ed. St Louis: Elsevier, Mosby, 2011: 1-98.
[10] Komune N, Matsuo S, Nakagawa T. The Fascial Layers Attached to the Skull Base: A Cadaveric Study[J]. World Neurosurg, 2019, 126: e500-e509. doi: 10.1016/j.wneu.2019.02.078
[11] Schachtel M, Gandhi M, Midwinter MJ, et al. Fascial layers encountered in the lateral skull base region: A cadaveric and radiological analysis[J]. Head Neck, 2023, 45(5): 1272-1280. doi: 10.1002/hed.27342
[12] Bradley PJ, Bradley PT, Olsen KD. Update on the management of parapharyngeal tumours[J]. Curr Opin Otolaryngol Head Neck Surg, 2011, 19(2): 92-98. doi: 10.1097/MOO.0b013e328342b9b4
[13] Prasad SC, Piccirillo E, Chovanec M, et al. Lateral skull base approaches in the management of benign parapharyngeal space tumors[J]. Auris Nasus Larynx, 2015, 42(3): 189-198. doi: 10.1016/j.anl.2014.09.002
[14] 薛凯, 刘全, 张焕康, 等. 内镜经口经翼下颌皱襞内侧入路的临床应用[J]. 中国耳鼻咽喉头颈外科, 2022, 29(4): 212-216. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT202204003.htm
[15] 张焕康, 李静, 蒋晓文, 等. 内镜经口侧颅底手术的解剖研究与临床应用[J]. 中华耳鼻咽喉头颈外科杂志, 2023, 58(5): 521-527.
[16] Mirapeix RM, Tobed Secall M, Pollán Guisasola C, et al. Anatomic Landmarks in Transoral Oropharyngeal Surgery[J]. J Craniofac Surg, 2019, 30(2): e101-e106. doi: 10.1097/SCS.0000000000004935
[17] Bejjani GK, Sullivan B, Salas-Lopez E, et al. Surgical anatomy of the infratemporal fossa: the styloid diaphragm revisited[J]. Neurosurgery, 1998, 43(4): 842-852. doi: 10.1097/00006123-199810000-00072
[18] Wang C, Kundaria S, Fernandez-Miranda J, et al. A description of arterial variants in the transoral approach to the parapharyngeal space[J]. Clin Anat, 2014, 27(7): 1016-1022. doi: 10.1002/ca.22273
[19] Strohl MP, El-Sayed IH. Contemporary Management of Parapharyngeal Tumors[J]. Curr Oncol Rep, 2019, 21(11): 103. doi: 10.1007/s11912-019-0853-8
[20] Polkowski M, Lenartowicz J, Zwoliński J, et al. Transoral endoscopic ultrasound-guided fine-needle biopsy of a tumor of the parapharyngeal space[J]. Endoscopy, 2021, 53(4): E145-E147. doi: 10.1055/a-1216-9928
[21] Gupta A, Chazen JL, Phillips CD. Imaging evaluation of the parapharyngeal space[J]. Otolaryngol Clin North Am, 2012, 45(6): 1223-1232. doi: 10.1016/j.otc.2012.08.002
[22] Eisele DW, Richmon JD. Contemporary evaluation and management of parapharyngeal space neoplasms[J]. J Laryngol Otol, 2013, 127(6): 550-555. doi: 10.1017/S0022215113000686
[23] Saito DM, Glastonbury CM, El-Sayed IH, et al. Parapharyngeal space schwannomas: preoperative imaging determination of the nerve of origin[J]. Arch Otolaryngol Head Neck Surg, 2007, 133(7): 662-667. doi: 10.1001/archotol.133.7.662
[24] Ducic Y, Oxford L, Pontius AT. Transoral approach to the superomedial parapharyngeal space[J]. Otolaryngol Head Neck Surg, 2006, 134(3): 466-470. doi: 10.1016/j.otohns.2005.10.003
[25] Shirakura S, Tsunoda A, Akita K, et al. Parapharyngeal space tumors: anatomical and image analysis findings[J]. Auris Nasus Larynx, 2010, 37(5): 621-625. doi: 10.1016/j.anl.2010.01.003
[26] Bulut OC, Giger R, Alwagdani A, et al. Primary neoplasms of the parapharyngeal space: diagnostic and therapeutic pearls and pitfalls[J]. Eur Arch Otorhinolaryngol, 2021, 278(12): 4933-4941. doi: 10.1007/s00405-021-06718-4
[27] Matsuki T, Miura K, Tada Y, et al. Classification of tumors by imaging diagnosis and preoperative fine-needle aspiration cytology in 120 patients with tumors in the parapharyngeal space[J]. Head Neck, 2019, 41(5): 1277-1281. doi: 10.1002/hed.25552
[28] Gangopadhyay M, Bandopadhyay A, Sinha S, et al. Clinicopathologic study of parapharyngeal tumors[J]. J Cytol, 2012, 29(1): 26-29. doi: 10.4103/0970-9371.93216
[29] Fermi M, Serafini E, Ferri G, et al. Management of parapharyngeal space tumors with transparotid-transcervical approach: analysis of prognostic factors related with disease-control and functional outcomes[J]. Eur Arch Otorhinolaryngol, 2022, 279(5): 2631-2639. doi: 10.1007/s00405-021-07074-z
[30] Galli A, Giordano L, Mattioli F, et al. The transcervical-transparotid corridor for management of parapharyngeal space neoplasms: strengths and limits in a bi-institutional retrospective series[J]. Eur Arch Otorhinolaryngol, 2024, 281(2): 897-906. doi: 10.1007/s00405-023-08256-7
[31] Battaglia P, Turri-Zanoni M, Dallan I, et al. Endoscopic endonasal transpterygoid transmaxillary approach to the infratemporal and upper parapharyngeal tumors[J]. Otolaryngol Head Neck Surg, 2014, 150(4): 696-702. doi: 10.1177/0194599813520290
[32] Fang Y, Wu H, Zhao W, et al. Endoscopic transvestibular anatomy of the infratemporal fossa and upper parapharyngeal spaces for clinical surgery: a cadaver study[J]. Eur Arch Otorhinolaryngol, 2019, 276(6): 1799-1807. doi: 10.1007/s00405-019-05410-y
[33] Gerges MM, Godil SS, Younus I, et al. Endoscopic transorbital approach to the infratemporal fossa and parapharyngeal space: a cadaveric study[J]. J Neurosurg, 2019, 133(6): 1948-1959.
[34] Ferrari M, Schreiber A, Mattavelli D, et al. Surgical anatomy of the parapharyngeal space: Multiperspective, quantification-based study[J]. Head Neck, 2019, 41(3): 642-656. doi: 10.1002/hed.25378
[35] Luna-Ortiz K, Villa-Zepeda O, Carrillo JF, et al. Parapharyngeal Space Tumor: Submandibular Approach Without Mandibulotomy[J]. J Maxillofac Oral Surg, 2018, 17(4): 616-624. doi: 10.1007/s12663-018-1133-0
[36] Chan JY, Li RJ, Lim M, et al. Endoscopic transvestibular paramandibular exploration of the infratemporal fossa and parapharyngeal space: a minimally invasive approach to the middle cranial base[J]. Laryngoscope, 2011, 121(10): 2075-2080. doi: 10.1002/lary.22159
[37] Horowitz G, Ben-Ari O, Wasserzug O, et al. The transcervical approach for parapharyngeal space pleomorphic adenomas: indications and technique[J]. PLoS One, 2014, 9(2): e90210. doi: 10.1371/journal.pone.0090210
[38] Okamoto I, Tsukahara K, Sato H. Parapharyngeal space tumor surgery using a modified cervical-parotid approach[J]. Acta Otolaryngol, 2018, 138(2): 165-169. doi: 10.1080/00016489.2017.1384058
[39] Cohen SM, Burkey BB, Netterville JL. Surgical management of parapharyngeal space masses[J]. Head Neck, 2005, 27(8): 669-675. doi: 10.1002/hed.20199
[40] Pradhan P, Preetam C, Parida PK, et al. Surgical Management of Parapharyngeal Space Tumours in a Single Tertiary Care Center[J]. Indian J Otolaryngol Head Neck Surg, 2018, 70(4): 531-537. doi: 10.1007/s12070-018-1447-8
[41] Kolokythas A, Eisele DW, El-Sayed I, et al. Mandibular osteotomies for access to select parapharyngeal space neoplasms[J]. Head Neck, 2009, 31(1): 102-110. doi: 10.1002/hed.20934
[42] Van Rompaey J, Suruliraj A, Carrau R, et al. Access to the parapharyngeal space: an anatomical study comparing the endoscopic and open approaches[J]. Laryngoscope, 2013, 123(10): 2378-2382. doi: 10.1002/lary.24121
[43] Panda S, Sikka K, Thakar A, et al. Transoral robotic surgery for the parapharyngeal space: expanding the transoral corridor[J]. J Robot Surg, 2020, 14(1): 61-67. doi: 10.1007/s11701-019-00932-3
[44] 刘全, 刘娟, 王欢, 等. 内镜经翼突及上颌窦前壁上咽旁间隙的解剖[J]. 解剖学报, 2021, 52(6): 940-944. https://www.cnki.com.cn/Article/CJFDTOTAL-JPXB202106020.htm
[45] Tubbs RS, Loukas M, Dixon J, et al. Compression of the cervical internal carotid artery by the stylopharyngeus muscle: an anatomical study with potential clinical significance. Laboratory investigation[J]. J Neurosurg, 2010, 113(4): 881-884. doi: 10.3171/2010.1.JNS091407
[46] 梁九思, 王小路. 经上颌窦入路咽旁段颈内动脉解剖标志个体化影像分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(9): 769-773. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2021.09.001
[47] Komune N, Komune S, Matsushima K, et al. Comparison of lateral microsurgical preauricular and anterior endoscopic approaches to the jugular foramen[J]. J Laryngol Otol, 2015, 129 Suppl 2: S12-20.
[48] 孙希才, 薛凯, 刘强, 等. 内镜经口入路咽后淋巴结切除术[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(2): 81-86. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2022.02.001
[49] Hu J, Ta J, Deisch J, et al. Image-guided transoral resection of recurrent parapharyngeal space glial heterotopia[J]. Int J Pediatr Otorhinolaryngol, 2014, 78(2): 366-369. doi: 10.1016/j.ijporl.2013.11.002
[50] Yokoyama J, Ooba S, Fujimaki M, et al. Impact of indocyanine green fluorescent image-guided surgery for parapharyngeal space tumours[J]. J Craniomaxillofac Surg, 2014, 42(6): 835-838. doi: 10.1016/j.jcms.2013.12.001
[51] Lim JY, Park YM, Kang MS, et al. Comparison of Surgical Outcomes of Robotic and Conventional Approaches in Patients with Pre-and Poststyloid Parapharyngeal Space Tumors[J]. Ann Surg Oncol, 2020, 27(11): 4535-4543. doi: 10.1245/s10434-020-08536-0
[52] 王振霖, 刘俊其, 危维, 等. 内镜经口咽鼓管后下入路切除鼻咽癌咽后转移淋巴结的单中心回顾性研究[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(11): 1328-1334. doi: 10.3760/cma.j.cn115330-20220418-00198
[53] He H, Yang Q, Gong J, et al. Endoscopic Transvestibular Transmandibular Approach for Trigeminal Schwannoma in Infratemporal Fossa and Parapharyngeal Space[J]. World Neurosurg, 2018, 118: 172-176. doi: 10.1016/j.wneu.2018.07.087
[54] Chen H, He Z, Li G, et al. Endoscopy-Assisted Transoral Approach to Resect Parapharyngeal Space Tumors: A Systematic Review and Meta-Analysis[J]. Laryngoscope, 2021, 131(10): 2246-2253. doi: 10.1002/lary.29458
[55] Li DF, Shi L, Wang J, et al. Endoscopic Trans-Lateral Molar Approach to Infratemporal Fossa Lesions[J]. Ear Nose Throat J, 2021, 100(10_suppl): 1017S-1022S. doi: 10.1177/0145561320934593
[56] Benet A, Plata Bello J, El-Sayed I. Combined Endonasal-Transcervical Approach to a Metastatic Parapharyngeal Space Papillary Thyroid Carcinoma[J]. Cureus, 2015, 7(7): e285.
[57] Fang Y, Wu H, Tan AD, et al. Transcervical endoscopic approach for parapharyngeal space: a cadaver study and clinical practice[J]. Acta Otolaryngol, 2020, 140(2): 163-169.
[58] O'Malley BW Jr, Weinstein GS. Robotic skull base surgery: preclinical investigations to human clinical application[J]. Arch Otolaryngol Head Neck Surg, 2007, 133(12): 1215-1219. doi: 10.1001/archotol.133.12.1215
[59] Chu F, De Berardinis R, Tagliabue M, et al. The Role of Transoral Robotic Surgery for Parapharyngeal Space: Experience of a Tertiary Center[J]. J Craniofac Surg, 2020, 31(1): 117-120. doi: 10.1097/SCS.0000000000005912
[60] Virós Porcuna D, Pardo Muñoz L, Viña Soria C, et al. A retrospective analysis of surgery in prestyloid parapharyngeal tumors: Lateral approaches vs transoral robotic surgery[J]. Laryngoscope Investig Otolaryngol, 2021, 6(5): 1062-1067. doi: 10.1002/lio2.662
[61] De Virgilio A, Costantino A, Mercante G, et al. Trans-oral robotic surgery in the management of parapharyngeal space tumors: A systematic review[J]. Oral Oncol, 2020, 103: 104581. doi: 10.1016/j.oraloncology.2020.104581
[62] Paderno A, Piazza C, Nicolai P. Recent advances in surgical management of parapharyngeal space tumors[J]. Curr Opin Otolaryngol Head Neck Surg, 2015, 23(2): 83-90. doi: 10.1097/MOO.0000000000000134
[63] Duek I, Amit M, Sviri GE, et al. Combined endoscopic transcervical-transoral robotic approach for resection of parapharyngeal space tumors[J]. Head Neck, 2017, 39(4): 786-790. doi: 10.1002/hed.24685
[64] Finegersh A, Holsinger FC, Gross ND, et al. Robotic Head and Neck Surgery[J]. Surg Oncol Clin N Am, 2019, 28(1): 115-128. doi: 10.1016/j.soc.2018.07.008
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