腮腺浅叶良性肿瘤功能性手术的初步探讨

目的:探讨功能性手术在腮腺浅叶良性肿瘤治疗中的应用.方法:从手术切口、耳大神经保留、区域性面神经解剖、腮腺浅叶部分切除术和凹陷性畸形整复等多个方面对腮腺浅叶良性肿瘤的手术方法进行改良和综合应用.回顾分析21例患者术后复发率及术后功能、并发症的情况.结果:随访未见肿瘤复发,无明显凹陷畸形,保留耳大神经者耳周感觉异常区域较...     

显微镜下功能性腮腺切除术治疗腮腺良性肿瘤42例

目的 评价显微镜下功能性腮腺切除术治疗腮腺良性肿瘤的临床疗效。方法 采用显微镜下功能性腮腺切除术,治疗腮腺浅叶良性肿瘤患者42例。该术式较传统术式改良之处主要有：全程显微镜下手术直观准确;切口改良、美容;腮腺嚼肌筋膜下翻瓣;解剖保留耳大神经后支和腮腺导管;只解剖暴露面神经的部分分支;包括肿瘤在内的腮腺浅叶部分切除;胸锁乳突肌肌瓣填塞术腔等。结果 42例术后出现面神经损伤3例(7.1%),损伤均为暂时性;出现Frey综合征者1例(2.4%);发生涎瘘者0例;5例(11.9%)患者术后出现不同程度的耳垂和耳郭背部皮肤感觉减弱;术后局部凹陷不明显,患者对颜面部外观满意。术后随访1～5年,未见肿瘤复发。结论 显微镜下功能性腮腺切除术治疗腮腺良性肿瘤,既降低手术并发症发生率,又可取得良好美容效果。     

保留腮腺浅叶手术治疗腮腺深叶良性肿瘤21例分析

目的探讨保留腮腺浅叶手术治疗腮腺深叶良性肿瘤的可行性。方法对1998～2012年收治的21例腮腺深叶良性肿瘤行保留腮腺浅叶手术切除肿瘤,并对手术疗效进行总结分析。结果采用保留腮腺浅叶手术治疗腮腺深叶良性肿瘤的21例患者术后无明显面部畸形、腮腺分泌功能良好,无Frey综合征;1例面神经损伤1个月后恢复;1例术后出现积液,加压包扎后痊愈。结论对于腮腺深叶良性肿瘤行保留浅叶腮腺深叶肿瘤切除术,术后面部畸形不明显,满足患者的美容要求,其他并发症少,值得临床推广应用。     

改良腮腺浅叶切除术治疗腮腺良性肿瘤

目的 探讨腮腺良性肿瘤切除术中保留腮腺咬肌筋膜、耳大神经和腮腺导管对降低术后并发症的作用.方法 回顾性分析56例腮腺良性肿瘤行肿瘤切除术的患者,保留腮腺咬肌筋膜、耳大神经和腮腺导管,术后予负压引流和局部加压包扎,观察并发症的发生率.结果 所有患者术后均随访,无1例复发.3例患者发生面神经损伤,均为一侧口角略歪斜,鼓腮稍...     

腮腺良性肿瘤切除方式及远期疗效观察

目的 探讨腮腺良性肿瘤不同切除方式及其远期疗效,手术并发症的评定.方法 回顾性分析我科1999～2006年手术治疗腮腺肿瘤患者病历资料75例.根据患者病变情况分别采用腮腺浅叶部分切除、全切除,全腮腺切除.术后随访5～10年.结果 采用腮腺浅叶部分切除者术后瘢痕、面部凹陷畸形、暂时性面瘫、Frey综合征、耳垂麻木的发生及腮腺功能均优于浅叶全切及腮腺全切除术.3种手术方式的复发率差异无统计学意义.结论 3种手术方式各有其优缺点,对于界限清楚,直径小于2.0cm的浅叶良性肿瘤,应尽量采用腮腺浅叶部分切除术.     

腮腺浅叶部分切除联合术中冰冻活检在治疗腮腺浅叶良性肿瘤中的应用

目的　探讨腮腺浅叶部分切除联合术中冰冻活检在腮腺浅叶良性肿瘤治疗中的应用价值。方法　回顾性分析采用腮腺浅叶部分切除联合术中冰冻活检治疗腮腺浅叶良性肿瘤126例（A组）及传统腮腺全切术治疗腮腺浅叶良性肿瘤100例（B组）的临床数据,比较两组病例近期及远期手术并发症的发生率及肿瘤复发率,并分析、讨论腮腺浅叶部分切除术的方法优势及注意事项。结果　短期并发症（感觉减退发生率、短暂性面神经乏力发生率、感觉减退发生率、Frey综合征发生率）,A组与B组比较,差异有统计学意义。A组病例中有1例患者术后病理结果提示低度恶性黏液表皮样癌,术后随访2年,未见复发。其余两组患者术后随访1~2年,未见复发。结论　腮腺浅叶部分切除具有并发症发生率低,创伤小的优点,同时并不增加肿瘤复发率,联合术中冰冻活检可以避免术中漏诊恶性肿瘤,值得在腮腺浅叶良性肿瘤的手术治疗中推广。     

腮腺良性肿瘤区域性切除术的临床探讨

腮腺良性肿瘤在临床上比较常见，传统的手术方法是进行肿瘤和腮腺浅叶切除术及面神经解剖术。1996-2006年间我科对31例腮腺良性肿瘤施行肿瘤及其周围腮腺组织切除术及部分面神经解剖术，取得了良好的临床疗效。现报告如下。     

腮腺肿瘤手术57例临床体会

目的探讨腮腺肿瘤手术方式、手术范围与治疗效果的关系。方法对1997～2003年间面神经解剖行腮腺肿瘤切除术57例(腮腺浅叶切除术51例，全腮腺切除术6例，1例行功能性颈淋巴结清扫术，术后加放疗4例)的临床随访资料进行分析。结果腮腺浅叶切除术51例中，并发暂时性面瘫5例，持续性面瘫1例，全腮腺切除6例中，并发暂时性面瘫2例，持续性面瘫2例，无腮腺瘘及Frey综合征，随访6月～7年无复发。结论腮腺良性肿瘤应施行解剖面神经的腮腺浅叶及肿瘤切除，恶性肿瘤在面神经尚未累及时行保留面神经的腮腺广泛切除，术后辅以放疗，可以减少肿瘤复发和面瘫等并发症的发生。     

Selective deep lobe parotid surgery for benign tumors

Conclusions: Deep-lobe tumor parotidectomy decreases the incidence of parotidectomy post-surgical complications, preserves parotid function, and has a good esthetic appearance. Objective: The existing surgical technique in the parotidectomy of deep-lobe benign tumors can be improved. Methods: Fourteen surgical operations were performed (2004–2015) for selective deep lobe parotidectomy for patients with primary benign parotid tumors. The patients with deep-lobe benign tumors were operated on with the method of superficial lobe preservation, which included methylene blue staining of the gland and intra-operative facial nerve detection. Results: During follow-up, no cases of tumor recurrence, permanent facial nerve injury, postparotidectomy depression, or Frey’s syndrome was found.     

腮腺良性肿瘤的手术方式与术后复发和并发症

目的;研究腮腺良性肿瘤手术方式与复发和术后并发症的关系。方法 在１９８７～１９９７年手术治疗腮腺良性肿瘤５５例（单纯肿瘤除２０例,腮腺浅地切除２８例,全腮腺切除７例）的临床随访资料进行分析。结果 单纯肿瘤切除中肿瘤复发６例,并发持续性面瘫１例,腮腺浅叶切除中复发１０例,并发暂时性面瘫４例腮腺瘘２例,Ｆｒｅｙ综合征２例,腮腺全切除中复发１例,并发暂时性面瘫２例,持续性面瘫１例,腮腺瘘２例,Ｆｒｅｙ综     

Seeding of tumor cells after fine needle aspiration cytology in benign parotid tumor: a case report and literature review

Fine needle aspiration cytology (FNAC) is generally considered a safe, sensitive, and specific diagnostic tool and is widely used for various clinical indications. However, some authors have raised concerns regarding the possibility of tumor cell seeding along the needle track. We present to our knowledge the first case of tumor seeding after FNAC of a benign parotid tumor. This is followed by a review of the literature on tumor seeding after aspiration with fine needles of 20 gauge and smaller and the implications for clinical practice.     

Effects of benign parotid tumors on unstimulated saliva secretion from the parotid gland

Objective

Salivary tumors can manifest as abnormalities of the gland itself and/or changes in salivary flow. However, effects of salivary tumors on saliva secretion have not been studied in much detail. The aim of the present study was to evaluate effects of benign parotid tumors on unstimulated saliva secretion from the affected gland.

Methods

Unstimulated parotid saliva was collected bilaterally using the swab method in patients with unilateral pleomorphic adenoma (n = 14) or Warthin's tumor (n = 6). Pre-weighted cotton rolls were placed at the opening of each parotid duct for 15 min.

Results

The range of salivary flow was similar to that found in studies on unstimulated parotid saliva. Salivary flow did not differ between the involved and non-involved side. No difference was found between the involved and non-involved side when the patients with pleomorphic adenoma or Warthin's tumor were separately analyzed.

Conclusion

The present results suggest that the most common benign parotid tumors do not alter unstimulated salivary flow from the affected gland.     

腮腺部分切除术在腮腺浅叶下极良性肿瘤中的临床价值

目的探讨腮腺部分切除术在腮腺浅叶下极良性肿瘤手术中的临床应用价值。方法回顾性研究2003年5月～2008年9月我院治疗的腮腺浅叶下极良性肿瘤患者127例,其中采用腮腺部分切除术48例,采用传统的腮腺浅叶切除术79例。所有患者随访1～5年,对比其并发症的发生率及肿瘤复发情况。结果腮腺浅叶切除术组面部畸形明显,暂时性面瘫发生率为17.7%（14/79）,味觉出汗综合征（Frey综合征）发生率为44.3%（35/79）,唾液瘘发生率2.5%（2/79）。腮腺部分切除术组患者术区面部畸形较轻,暂时性面瘫发生率为4.2%（2/48,P〈0.05）,Frey综合征发生率为10.4%（5/48,P〈0.05）,本组无唾液瘘发生。两组患者随访期间均无肿瘤复发。结论腮腺部分切除术具有手术创伤小、并发症少、术后面部畸形小等优点,是腮腺浅叶下极良性肿瘤治疗的理想术式。     

Extracapsular dissection for Warthin tumor in the tail of parotid gland

Conclusions: Extracapsular dissection conferred the advantage of reduced operation time and morbidity without any recurrence, and it could be considered as the treatment of choice for Warthin tumors in the tail of the parotid gland.

Objective: The purpose of this study is to confirm the appropriate surgical procedure for Warthin tumor in the tail of the parotid gland, by comparing the results of extracapsular dissection and superficial parotidectomy.

Materials and methods: The medical records of 72 patients with Warthin tumor in the tail of the parotid gland who underwent surgery between January 2006 and December 2016 were retrospectively reviewed.

Results: In the extracapsular dissection group, a total of 44 parotid gland operations were performed in 40 patients. In the superficial parotidectomy group, a total of 34 parotid gland operations were performed in 32 patients. The operation time was significantly shorter in the extracapsular dissection group than in the superficial parotidectomy group (p<.001, Table 1). One patient in the extracapsular dissection group and five patients in the superficial parotidectomy group had postoperative facial nerve palsy. Recurrence of Warthin tumor in the tail portion of the parotid gland was identified in one patient who underwent superficial parotidectomy.     

腮腺良性肿瘤切除中胸锁乳突肌皮瓣的应用分析

目的 探讨腮腺良性肿瘤切除中胸锁乳突肌皮瓣的应用效果。 方法 选取腮腺良性肿瘤患者84例,以随机数字表法分成对照组和实验组,各42例。对照组接受常规腮腺切除术治疗,实验组常规切除腮腺病变后,采用胸锁乳突肌皮瓣转移填充术区凹陷行修复治疗。随访6~12个月,对比两组术后并发症发生率和肿瘤复发率。 结果 实验组术后并发症发生率14.29%,低于对照组的52.38%,差异有统计学意义(P<0.01)。两组肿瘤复发率差异无统计学意义(P>0.05)。 结论 在腮腺良性肿瘤切除中应用胸锁乳突肌皮瓣修复术区凹陷,可有效降低并发症风险,同时不影响手术效果,值得临床推广。