Shenzhen Business Daily Reading Client Reporter Zhao Hongfei Correspondent Huang Zuofeng He Yue
I haven't snored for half a year, and now everything is normal, and I can't believe that this egg-sized tumor was cut off 'unscathed'. Recently, Mr. Liu (pseudonym) said excitedly during the re-examination of the otolaryngology clinic of Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital).
It turned out that half a year ago, Mr. Liu (pseudonym) was found to have an "egg-size" parapharyngeal skull base tumor due to serious snoring, and with the help of the team of chief physician Li Shuo of the Department of Otolaryngology of Nanshan Hospital, the tumor was successfully removed from the entrance of the mouth, avoiding scars on the face and saving his appearance.
Found a large tumor in an egg and want to split the chin for surgery?
Mr. Liu was always complained by his wife that "his snoring in sleep is getting worse and worse, and he can't sleep at all", so he went to a hospital near his home for a medical examination, but he was shocked.
The examination found that the soft palate on the right side of Mr. Liu's mouth was significantly bulging, which affected the ventilation of the throat. After taking the film, I saw that there was a 45*5.5*6.A 2cm large parapharyngeal space tumor, this tumor is larger than an egg, no wonder Mr. Liu's snoring is so serious.
Although the test results are positive, the tumor has compressed the surrounding large blood vessels and nerves, and surgery must be removed as soon as possible.
How to cut such a large tumor? Due to the special location of the parapharyngeal space, from the base of the skull to the hyoid bone, the position is deep, and the anatomical relationship is complex, so the operation is generally difficult.
According to the best plan provided by the hospital, it is necessary to split the chin and lift the face for surgery, so that the tumor can be completely exposed and removed, so as to facilitate the removal of the tumor. However, because the surgery is more traumatic and bleeding, the recovery period after surgery is longer, and it will also leave a large scar on the face.
Will you have to leave a big scar on your face in the future? After listening to this, Mr. Liu felt "shuddering", and the doctor's plan made him feel very depressed for a while.
In order to find a better way, Mr. Liu and his family inquired around, and finally found out that the Department of Otorhinolaryngology of Nanshan Hospital has a minimally invasive surgical plan, which can remove the tumor under the endoscope, and only need to make an incision in the mouth, without "disfigurement".
Mr. Liu came to the outpatient clinic of Chief Physician Li Shuo of the Department of Otorhinolaryngology. After a physical examination and detailed review of his imaging data, Li Shuo judged that Mr. Liu's tumor could be removed by mouth under endoscopy, but due to the large size and deep location of the tumor, the risk of surgery increased significantly.
Removing a tumor is like dancing a sword on a cliff, and if you are not careful, it will cause serious complications, because the tumor compresses or adjoins the main blood supply arteries of the head and neck - the internal carotid artery, the external carotid artery, and once the blood vessel such as the internal carotid artery ruptures and bleeds, there is a risk of death. Li Shuo said.
With multidisciplinary collaboration, large egg tumors are removed from the oral cavity
Li Shuo's team conducted in-depth research on the patient's tumor images, and invited neurointerventional, oral and maxillofacial imaging, imaging, anesthesia and other departments to consult, ready to work together to fight this tough battle. The surgical pathway, risks, and preparation options were discussed, especially in the event of massive bleeding during surgery, and preparations should be made to embolize the unilateral internal carotid artery. For this reason, the Department of Neurointerventional Medicine performed a balloon occlusion test of the internal carotid artery on the affected side in advance.
After thorough preoperative preparation, Mr. Liu's surgery was carefully performed in a hybrid operating room escorted by DSA (cerebral angiography). With the assistance of Li Shuo and 4 other doctors in the team, an opening of about 4cm was incised on the patient's oral mucosa through an endoscope, and then separated layer by layer, and finally the egg-sized tumor was completely and cleanly removed after nearly 4 hours.
The surgery went smoothly, there was no damage to important nerves and blood vessels, and the risks that were expected before the operation did not occur.
After the operation, Mr. Liu had no other discomfort except for some pain at the incision next to the soft palate. One week later, Mr. Liu recovered and was discharged from the hospital. Mr. Liu came to the hospital for re-examination 3 months and half a year after the operation, and the examination showed that the tumor was completely resected and there was no **.
I can't tell from the outside that I've had surgery now, but I'm glad I found you! Six months have passed, and Mr. Liu and his family, who thought they were going to "break the phase", are very grateful to the otolaryngology.
Li Shuo introduced that on the one hand, the parapharyngeal space is in a special position, and the operation is difficult. On the other hand, due to the insidious location and slow growth of the tumor, there are usually no obvious symptoms in the early stage. When the surrounding tissues, blood vessels and nerves are compressed, it is found that the tumor is relatively large, and the difficulty of surgery will be significantly increased.
In order to have a good visual field of view, traditional surgery mostly adopts single or combined approaches such as mandibular splitting, transparotid, and transcervical, which have the consequences of large damage, slow recovery, facial paralysis, and facial scarring. Transoral endoscopy makes use of the unique minimally invasive advantages of endoscopy, with small damage, fast recovery and clear vision, which avoids complications such as abnormal jaw bite, cheek numbness, decreased or disappearance of pain and touch sensation after the mandible ascending branch is severed, and at the same time can save the patient's lifelong "face" problem.