腫瘍内出血により気道閉塞をきたした副咽頭間隙腫瘍症例

A case of parapharyngeal space tumor complicated by air way obstruction following intra-tumor hemorrhage

Ⅰ．はじめに

　副咽頭間隙に発生する腫瘍は全頭頸部腫瘍の0.5％を占め，その70～80％は良性で残りの20～30が悪性とされている^1）。神経鞘腫，多形腺種，傍神経腫などが大部分を占め^2），約50％が無痛性頸部腫脹にて発見されると報告^3）されている。今回われわれは腫瘍内出血により急激に増大し，気道閉塞をきたした副咽頭間隙腫瘍の1例を経験したのでその概要を報告し，あわせて文献的考察を行った。

　We reported a case of parapharyngeal space tumor with air way obstruction following intra-tumor hemorrhage. The tumor was located in the prestyloid region in MRI. On initial consultation, the patient refused surgical operation. Nine months later, the tumor size suddenly increased in a few days. The patient noticed dyspnea and right facial nerve palsy. We urgently performed a tracheotomy and resected the tumor by a transcervical and mandibular swing approach. There was a case showing sudden increase in size such as this report, we should have surgical procedure to prestyloid parapharyngeal space tumors in early stage.