【作者】 张艳； 李树玲； 刘经组； 葛正津； 徐本义； 丁浦训； 杨力珍； 张仑； 高明； 程文元；

【Author】 Zhang Yan Li Shu-Ling Liu Jing-Zu Ge Zheng-Jin Xu Ben-Yi Ding Pu-Xun Yang Li-Zhen Zhang Lun Gao Ming Cheng Wen-Yuan Department of Head And Neck Surgery Tianjin Medical University Cancer Hospital

【机构】 天津医科大学附属肿瘤医院头颈二科；

【摘要】 目的:分析86例头颈部副神经节瘤诊治情况。方法:回顾性分析天津肿瘤医院自1956年11月-2006年5月共诊治头颈部副神经节瘤86例,其中颈动脉体瘤79例,迷走神经体瘤6例,喉副神经节瘤1例。结果:86例中男性38 例,女性49例,男与女之比为1:1．29,年龄由14岁至62岁, 中位年龄为43．9岁。79例颈动脉体瘤中双侧2例,共81个肿瘤。85例(87个肿瘤)颈动脉体瘤及迷走神经体瘤多以颈部肿物就诊,自发病至就诊为期数月至30年,平均8年,来院前曾在外院手术(肿物部分切除、切检或手术探查)30例, 其中11例合并神经损伤。采用Shamblin分型,I型29例, Ⅱ型19例,Ⅲ型39例。除喉副神经节瘤行喉切除术外,其余87个(85例)肿瘤动脉外膜下肿瘤切除术57例,肿瘤合并颈动脉切除术30例,进行动脉吻合4例,术后出现脑神经并发症5例。恶性3例。结论:彩超、CTA及MRA均为副神经节瘤的主要诊断手段,但DSA仍然是诊断的金标准。术前颈动脉压迫是重要的术前准备。术中细致操作、仔细将肿物与动脉解离,控制出血及保证脑组织的血液供给是手术的关键;根据情况可行动脉移植。术前介入行瘤体检塞可减少术中出血。更多还原

【Abstract】 Objective: to analyze the diagnosis and treatments by 86 cases of paraganglioma in head and neck. Methode:retrospective analysis of 86 cases of paraganglioma in head and neck which therapied in Tianjin oncology hospital from November 1956 to May 2006, among them, 79 cases are carotid body tumor , 6 cases are vagus nerve body tumor, 1 case is the larynx paraganglioma. Results: in 86 cases, male 38, female 49, M/F is 1: 1.29, The age from 14 to 62 years old, mean is 43.9 years old. in 79 cases of carotid body tumor, 2 cases are bilateral, the number of tumors are 81. In 85 cases (87 tumors) of the patients of carotid body tumor and vagus nerve body tumor, the main symptom are neoplasm in neck, the time from have symptoms to come to hospital are several months till 30 years, mean is 8 years. 30 cases have been operated in another hospital before hospitalization(tumor part-resection, biopsy or exploration), 11 cases have nerve injury. By Shamblin’ s types, type I 29 cases, type II 19 cases, type III 39 cases. laryngectomy have been done only in the patients of vagus nerve body tumor. Tumor resection have been done in 57 cases, 30 cases have been done the operations of tumor resection and carotid resection at mean time, 4 cases have been done the artery anastomose, CNS complications are occurred in 5 cases postoperation. 3 Cases are malignancy. Coneluslon:Color Doppler ultrosonography,CTA and MRA are all the main diagnosis means of paraganglioma, but DSA is still the diagnostic golden standard. The carotid artery oppression is very important before operation. During operation, careful leave the tumor and the artery, control bleed and promise the brain organization of the blood supply is the key of the surgical operation, artery transplantation can be done according to the circumstance.before operation ,the tumor vasoembolism can be used to reduce bleed lose during operation.更多还原