頭頸部癌の副咽頭腔進展（第1報）

Parapharyngeal Space Invasion of Head and Neck Cancer

I．はじめに

　咽頭の癌は高頻度に咽後リンパ節（RPL）に転移する^1,2,3）。とくに側上方のいわゆるRouvierリンパ節への転移は，診断が難しいが，頻度が高いと推定される。転移か直接進展か断定できないが，咽頭や口腔後部の癌が少なからず副咽頭腔（PPS）に進展することを最近経験した。この部位への進展はcomputed tomography（CT）の進歩により以前に比して容易になったので，CTを応用してPPSへの進展を診断し，PPSへ進展しやすい頭頸部扁平上皮癌の原発部位，進展部位，組織学的検査による癌の深達度，PPSへ進展時の臨床症状を検討した。

　We studied parapharyngeal space invasion in 127 patients with epidermoid cancers of the pharynx, posterior oral cavity and epilarynx by means of computed tomography, histopathology and clinical examinations.

　Of the patients examined 18 (14.7%) were found the parapharyngeal invasions (27.7% in mesopharyngeal cancers, 21.2% in hypopharyngeal cancers, 10.7% in oral cancers).

　These invasions were frequent when cancers involved deeply the palatine arch, tonsil, retromolar region, pharyngoepiglottic fold and base of tongue, and initiated by metastasis to the parapharyngeal lymph nodes from cancers in the hypopharynx and oral cavity and by direct extension from the mesopharyngeal cancers.

　These invasions frequently induced such symptoms as trismus, swelling of the lateral pharyngeal wall, infraauricular and submandibular regions, facial pain and facial palsy.