经口腔内窥镜在三维可视化及实时导航技术下切除咽旁及侧颅底良性肿瘤初探

doi:10.7518/hxkq.2024.2023239

华西口腔医学杂志 ›› 2024, Vol. 42 ›› Issue (1): 104-110.doi: 10.7518/hxkq.2024.2023239

经口腔内窥镜在三维可视化及实时导航技术下切除咽旁及侧颅底良性肿瘤初探

闫冰¹(), 骆献阳²^,³^,⁴, 胡妮婷²^,³, 洪志聪²^,³^,⁴, 关丽梅²^,³^,⁴, 薛丽丽³^,⁵()

^1.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院头颈肿瘤外科，成都 610041
^2.厦门大学附属第一医院耳鼻咽喉头颈外科，厦门 361003
^3.厦门大学医学院，厦门 361003
^4.厦门市耳鼻咽喉头颈外科重点实验室，厦门 361003
^5.厦门大学附属第一医院口腔科，厦门 361003

收稿日期:2023-07-28 修回日期:2023-11-25 出版日期:2024-02-01 发布日期:2024-01-12
通讯作者: 薛丽丽 E-mail:yanbing_west@163.com;xuelili0596@163.com
作者简介:闫冰，副主任医师，博士，E-mail：yanbing_west@163.com

Preliminary study on the resection of parapharyngeal and lateral skull base tumors by using transoral endoscopy with 3D visualization and navigation technologies

Yan Bing¹(), Luo Xianyang²^,³^,⁴, Hu Niting²^,³, Hong Zhicong²^,³^,⁴, Guan Limei²^,³^,⁴, Xue Lili³^,⁵()

^1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^2.Dept. of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China
^3.School of Medicine, Xiamen University, Xiamen 361003, China
^4.Xiamen Key Laboratory of Otolaryngology Head and Neck Surgery, Xiamen 361003, China
^5.Dept. of Stomatology, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China

Received:2023-07-28 Revised:2023-11-25 Online:2024-02-01 Published:2024-01-12
Contact: Xue Lili E-mail:yanbing_west@163.com;xuelili0596@163.com

摘要/Abstract

摘要：

目的开展在三维可视化技术及术中实时导航辅助下，采取经口腔入路内窥镜下切除咽旁及侧颅底肿瘤的初步研究。方法对8例咽旁或侧颅底区域的软组织肿瘤患者术前CT数据建模，通过三维可视化技术重建肿瘤与周围血管及其他重要结构的解剖位置关系，进行术前设计。术中采取经口腔入路，术中实时导航引导，内窥镜下切除咽旁及侧颅底软组织肿瘤，并评估该方法的临床应用价值。结果 8名患者采用该技术进行手术，术中失血量均控制在150 mL以内，平均失血量约125 mL。术后患者并发症发生率低，通过术后功能训练，患者均能够获得良好恢复。因采用经口入路，患者术后面部皮肤无伤口无瘢痕，对患者容貌无影响。结论三维可视化技术、术中实时导航及内窥镜三者联合为咽旁肿瘤或侧颅底肿瘤患者提供了一种美观、安全、微创的手术方式。

关键词: 三维可视化技术, 导航技术, 内窥镜, 咽旁肿瘤, 侧颅底肿瘤

Abstract:

Objective With the assistance of 3D visualization and real-time navigation technologies, the tumors in the parapharyngeal and lateral skull base should be removed through oral the approach with endoscopy. Methods The preoperative CT data of eight patients with parapharyngeal or lateral skull base soft tissue tumors were modeled, and the anatomical position relationship between the tumor and surrounding blood vessels and other important structures was reconstructed using 3D visualization technology, and preoperative design was performed. The intraoperative oral approach and real-time navigation guidance were adopted in the endoscopic resection of soft tissue tumors in the parapharyngeal and lateral skull base, and the clinical application value of this method was evaluated. Results The blood loss during the operation was controlled within 150 mL, and the average blood loss was approximately 125 mL. The incidence of postoperative complications was low, and patients could recover well through functional training. The oral approach did not leave any wounds nor scars on the patient’s facial skin after the operation and had no effect on the patient's appearance. Conclusion The combination of 3D visualization technology, intraoperative real-time navigation, and endoscopy provides a beautiful, safe, and minimally invasive surgical method for patients with parapharyngeal or lateral skull base tumors.

Key words: 3D visualization technology, navigation technology, endoscope, parapharyngeal tumor, lateral skull base tumor

中图分类号:

R782.05

闫冰, 骆献阳, 胡妮婷, 洪志聪, 关丽梅, 薛丽丽. 经口腔内窥镜在三维可视化及实时导航技术下切除咽旁及侧颅底良性肿瘤初探[J]. 华西口腔医学杂志, 2024, 42(1): 104-110.

Yan Bing, Luo Xianyang, Hu Niting, Hong Zhicong, Guan Limei, Xue Lili. Preliminary study on the resection of parapharyngeal and lateral skull base tumors by using transoral endoscopy with 3D visualization and navigation technologies[J]. West China Journal of Stomatology, 2024, 42(1): 104-110.

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编号	年龄/岁	性别	肿瘤部位	肿瘤大小	手术时间	术中出血/mL	病理结果	术后张口度/cm
1	32	男	颞下窝	5 cm×3 cm×2 cm	3 h	150	神经鞘瘤	3.5
2	58	女	咽旁及侧颅底	3 cm×2.5 cm×1 cm	3 h 2 min	130	多形性腺瘤	4
3	60	女	咽旁	3 cm×2 cm×1 cm	2 h 20 min	130	多形性腺瘤	3.7
4	62	男	咽旁	5 cm×2 cm×1.5 cm	2 h	120	肌上皮瘤	3.8
5	40	男	咽旁	4 cm×2 cm×1.5 cm	1 h 10 min	100	上皮源性囊肿	3.5
6	45	男	咽旁	3 cm×2 cm×1 cm	1 h 20 min	100	上皮源性囊肿	3.8
7	68	女	颞下窝	2.5 cm×1 cm×1 cm	2 h	150	神经鞘瘤	3.5
8	70	男	咽旁及侧颅底	4 cm×3 cm×1.5 cm	1 h 40 min	120	多形性腺瘤	3.8

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经口腔内窥镜在三维可视化及实时导航技术下切除咽旁及侧颅底良性肿瘤初探

Preliminary study on the resection of parapharyngeal and lateral skull base tumors by using transoral endoscopy with 3D visualization and navigation technologies

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