腮腺切除改良术式治疗腮腺良性肿瘤

目的了解腮腺切除改良术式治疗腮腺良性肿瘤的临床疗效。方法采用腮腺切除改良术式共治疗35例腮腺良性肿瘤患者，术式改良内容包括除皱术手术切口、解剖保留耳大神经后支、胸锁乳突肌肌瓣填塞术区、术后负压引流。结果本组35例患者术后出现Frey综合征者2例，发生涎瘘者1例，出现暂时性面神经功能减弱者7例，术侧耳垂和耳廓背部皮肤感觉均暂时性减弱，术后美容效果满意率100％。结论腮腺切除改良术式治疗腮腺良性肿瘤既可取得良好的美容效果，又可降低并发症发生率，值得在临床推广。     

不结扎腮腺管的腮腺部分切除术治疗腮腺良性肿瘤

目的 探讨腮腺良性肿瘤腮腺部分切除术的方法及效果。方法 对15例16侧腮腺良性肿瘤实施了不结扎腮腺管的腮腺部分切除术，手术多采用循下颌缘支的方法解剖面神经颈面干，肿瘤外0．5～1．0cm切除肿瘤与部分腺体。结果 15例手术病人，均未出现涎瘘等手术并发症。术后瘢痕小，面部畸形轻微，保留了部分腮腺功能，随访期内未见肿瘤复发。结论 腮腺部分切除术对与发生于腮腺后下部的良性肿瘤，是一种效果肯定的治疗方法。     

保留腮腺咬肌筋膜的腮腺切除术

目的:探讨在腮腺切除手术的同时保留并重建腮腺咬肌筋膜是否能够有效预防味觉出汗综合征的发生。方法:通过对 31例在腮腺切除术中保留、重建腮腺咬肌筋膜的患者进行术后随访,并采用咀嚼维生素C片诱导及碘 淀粉试验检测,观察术后味觉出汗综合征的发病率。结果:在调查的 31例患者中,仅有 3例患者发现有潮红和出汗现象,较传统腮腺切除术的发病率明显降低,发生率仅为 9. 69%。结论:切除腮腺时保留并重建腮腺咬肌筋膜对术后味觉出汗综合征的预防有显著效果。     

保存性腮腺切除术治疗腮腺癌

保存性腮腺切除术不同于经典的解剖面神经的腮腺浅叶切除。该文旨在评价保存性腮腺切除术治疗腮腺恶性肿瘤的效果。对1992～2002年间的43例腮腺癌患者进行回顾性研究。肿瘤均位于腮腺浅叶,并接受了保存性腮腺切除术。其中男16例,女27例；年龄8～84岁；16例(37%)为低分化,27例(63%)为高分化。24例在切除原发灶同时行颈淋巴清扫术,10例术后行辅助放疗；随访8～130个月,平     

结扎腮腺导管后腮腺萎缩的显微镜观察

作者采取18只体重为350～500克的成熟白鼠,在成巴比妥钠麻醉下(0.1毫升/100克体重),结扎一侧腮腺导管。在1～90天内不同的间隔,将动物杀死,取出结扎导管后的腮腺组织,经过固定、切片、染色,进行光学显微镜和电子显微镜的观察。观察结果:大体解剖所见,结扎腮腺导管后,初期腮腺肿大,以后则进行性萎缩,更晚期则残留部分腺体,一直观察3个月,腮腺组织也未见恢复正常。光学显微镜见初期导管扩张充盈,腮腺腺泡体积增大,细胞浅染,4～6天以后,腮腺腺泡变小且减少,胞浆逐渐浅染,有的腺泡长大且空泡形成,偶见核固缩。2～3周以后,结缔组织明显增多,导管扩张,导管的     

腮腺转移瘤

腮腺肿瘤约占全身肿瘤的3%,大多数是原发的。对于腮腺肿瘤的诊断可参照所谓“80%规律”,即80%的涎腺肿瘤发生在腮腺;其中80%为良性;在这些良性肿瘤中有80%是混合瘤。在提到腮腺的恶性肿瘤时,人们往往考虑的是原发肿瘤。其实,由于腮腺内、外淋巴结的存在,恶性肿瘤是可以转移到腮腺区的,在进行腮腺区肿块的鉴别诊断时,应当考虑到腮腺转移瘤。     

腮腺造影用于腮腺疾病的诊断112例分析

目的探讨腮腺造影对腮腺疾病的诊断价值。方法回顾性分析112例139个腺体的腮腺造影影像学特征及诊断结果。结果舍格伦综合征38例、儿童复发性腮腺炎27例、慢性阻塞性腮腺炎29例,其影像学表现符合其各自的特征性表现而得到确诊,良性肥大8例中的2例结合B超检查确诊,腮腺肿瘤10例中有2例结合B超检查定性。结论腮腺造影对腮腺非肿瘤性疾病有诊断价值,腮腺肿瘤应结合病史、化验并配合高频超声等其他手段提高诊断准确率。     

腮腺造影断层

腮腺造影对于判定肿瘤性质有一定价值,方法简单、价格低廉,广泛应用于腮腺疾病的诊断。然而,该方法对于体积较小的肿瘤常不能显示,腺内外肿块的鉴别也有一定困难。近两年来,我们对40例腮腺肿瘤患者进行了腮腺造影断层(从下简称断层)检查,发现在一定程度上可弥补常规腮腺造影(以下简称造影)的缺点。两者结合应用,可提高诊断准确率。材料和方法40例腮腺肿瘤患者,其中男性19例,女性21例。年龄介于20～72岁,平均46.6岁。全部病例经手术治疗,均有病理证实。其中良性肿瘤33例,恶性肿瘤7例,详见附表。     

功能性腮腺切除术治疗腮腺浅叶良性肿瘤的临床研究

目的:探讨功能性腮腺切除术在腮腺浅叶良性肿瘤治疗中的临床应用价值.方法:腮腺浅叶良性肿瘤首发病例56例,肿瘤直径均≤3.0 cm,采用功能性腮腺切除术治疗,在距肿瘤边界0.5～1.0 cm处的正常腺体内切除肿瘤,随访0.5～5年,观察并发症的发生率及肿瘤复发情况.并与传统腮腺切除术相比较.结果:56例患者术后面部畸形较轻,腮腺功能良好.随访期间肿瘤无复发、无涎瘘、味觉出汗综合征,其中4例出现暂时性面瘫.与传统腮腺切除术相比,肿瘤复发率比较无统计意义(P＞0.05),两组术后口干、暂时性面瘫、涎瘘和Frey's综合征的发生率有统计学意义(P＜0.05).结论:功能性腮腺切除术可以作为体积较小(≤3.0 cm)的腮腺浅叶良性肿瘤治疗的理想术式.     

功能性腮腺切除术治疗腮腺深叶良性肿瘤

目的：探讨保存功能性外科在腮腺深叶肿瘤切除术中的应用及疗效。方法：17例腮腺深叶良性肿瘤患者,其中位于深叶者12例,累及浅深2叶者5例,直径均≤3 cm。采用制备筋膜腺体瓣并预留出将要切除的肿瘤及周围腺体的方法,完整切除腮腺深叶及肿瘤同时保存腮腺浅叶功能。结果：全部患者的手术均顺利完成,创口均Ⅰ期愈合,无涎瘘,外形满意;暂时性面瘫发生2例（11．76％）。17例均获随访,随访时间6～24个月,平均11个月。未见肿瘤复发;面瘫基本消失。结论：应用功能性腮腺切除术治疗腮腺深叶良性肿瘤能有效保存腺体功能,减少面部凹陷畸形及味觉出汗综合征等并发症。     

Bilateral parotid gland aplasia

Bilateral parotid gland aplasia is a cause of xerostomia. A case is presented in which the clinical diagnosis was confirmed with the use of 99mTcO-4 salivary gland scintiscanning and computerised tomography. The literature of this rare condition is reviewed and significance to the patient discussed.     

Accessory parotid gland masses

Three cases of accessory parotid gland lesions are reported. The literature concerning accessory gland disease and its diagnosis and treatment is reviewed.     

Congenital parotid gland fistula

A rare case of congenital parotid gland fistula is reported. A 4-year-old boy presented with a fistula opening at the facial surface of the skin posterior to the left commissure of the lips. This fistula originated from an accessory parotid gland with a duct entirely distinct from the original Stensen's duct. Because of the salivary outflow from the fistula opening, the opening was translocated to the oral cavity using Delore's method.     

Expression of CD44 standard and variant isoforms in parotid gland and parotid gland tumours

In this study, we investigated the distribution of the standard form of the CD44 (CD44s) cell adhesion molecule and of its v3 and v6 isoforms in samples of foetal and adult parotid gland tissue, in comparison with samples of parotid gland adenomas and carcinoma ex pleomorphic adenoma. Foetal parotid gland showed CD44s and CD44v3 expression in the peripheral small primordial ducts and acini, while CD44v6 was only focally expressed. Adult parotid gland tissue showed a similar distribution of CD44s and variants, with a predominant expression in acinar structures and a weaker expression at duct level. In parotid gland adenomas, a diffuse and intense expression of CD44s and variants 3 and 6 was observed only in pleomorphic adenomas, while expression of CD44s was prevalent in Warthin's tumour, myoepithelioma and oncocytoma. The malignant areas of carcinoma ex pleomorphic adenoma showed a markedly decreased expression of CD44v3 and CD44v6 in comparison with the adjacent pleomorphic adenoma component. In conclusion, the prevalent expression of CD44s and variants in pleomorphic adenoma in comparison with other adenomas may be related to the abundant extracellular matrix production present in these tumours, while loss of CD44v3 and CD44v6 associated with the onset of carcinoma ex pleomorphic adenoma could promote stromal invasion, eventually contributing to the development of distant metastases.     

Bilateral oncocytoma in the parotid gland

Oncocytomas are rare tumors in the head and neck region. They occur commonly in salivary glands, especially in parotid glands. The prevalence is 0.5% to 1.2% in parotideal neoplasms. Oncocytomas rarely occur bilaterally. To our knowledge, only 20 cases were reported in the literature. A case with bilateral oncocytoma was presented with clinical, radiologic, and pathologic findings and treatment options in this study.     

Angiolithiasis in the parotid gland.

Angiolithiasis in salivary glands is a very rare finding, and the knowledge of the morphology and histogenesis of these stone formations is therefore limited. Six small angioliths from the left parotid gland of a 19-year-old girl were examined histologically, microradiographically and diffractometrically. The angiolithiasis developed from a regressed hemangioma which had been observed since the patient was 3--4 years old. The angioliths, which were encapsulated, exhibited in some areas diffuse laminations with shells of alternatingly high and low mineral content. In other areas, however, the sturcture of the stones was rather homogeneous. The central part of all angioliths was highly mineralized. All the examined specimens exhibited a mineral pattern of pure apatite. Due to presence of erythrocytes as well as of fibroblasts in the matrix of the examined noduli, the diagnosis of angiolithiasis was established.     

Kimura disease in the parotid gland

Kimura disease (KD) is a rare entity that occurs primarily in Asian people characterized histopathologically by a lymph-folliculoid granuloma with infiltration of the mass and the surrounding tissues by eosinophils, often with concomitant peripheral blood eosinophilia and elevated serum immunoglobulin E, generally seen in the head and neck region, especially preauricular area. In this article, we present the case of a 14-year-old male patient with KD on his left parotid area. The clinical, radiologic, surgical, and pathologic findings of KD are discussed in this article.