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患者女,29岁。因上腭部不适2年、发现肿块2月余于2000年3月3日入院。患者起初仅感腭咽部不适,近来出现肿块且逐渐长大,吞咽受阻,夜间睡眠时感呼吸困难,常常被憋醒。查体:上软腭部左侧有一约7cm×5cm大小包块,界限清且固定,质中等,表面光滑,无压痛,未扪及波动感,悬雍垂被挤向右侧,咽腭腔缩小:各腺体分泌如常,咽部无充血,扁桃体不肿大。CT示左侧咽旁有一7cm×5cm密度不均之块影(CT值26—52HU),上达鼻咽腔,下至舌骨平面,向内压迫口咽,鼻咽腔变小,咽隐窝及咽鼓管隐窝均消失,未见明确的骨质破坏。术前诊断:腭咽部良性肿瘤。3月13日在全麻下行气管切开,肿瘤摘除术。病理检查:大体标本,椭圆形肿物1个,大小7cm×6cm×3.5cm,包膜完整;切面灰白、灰黄,呈漩涡状小结节样;质地中等偏硬,有韧感。镜
Patient female, 29 years old. Due to the upper palate discomfort for 2 years, found that the mass in February February 3, 2000 admitted to hospital. Patients initially felt only velopharyngeal discomfort, recent mass and gradually grow up, swallowing obstruction, difficulty breathing during nighttime sleep, often being aroused. Physical examination: on the left side of the soft palate with a size of about 7cm × 5cm mass, clear boundary and fixed, medium quality, smooth surface, no tenderness, no palpable flu, uvula squeezed to the right, pharyngeal and palate narrow : The secretion of the normal glands, throat no congestion, tonsil does not enlarge. CT showed a left side of the parapharyngeal 7cm × 5cm uneven density block (CT value 26-52HU), on the nasopharyngeal cavity, down to the hyoid plane, inward pressure oropharyngeal, nasopharyngeal smaller, pharyngeal hidden Wo and eustachian tube crypt disappeared, no clear bone destruction. Preoperative diagnosis: velopharyngeal benign tumor. March 13 tracheotomy under general anesthesia, tumor removal surgery. Pathological examination: gross specimen, oval tumor 1, the size of 7cm × 6cm × 3.5cm, complete capsule; section gray, gray, swirling small nodules; texture medium hard, resilient. mirror