良性腮腺瘤手术中保留耳大神经的临床研究

目的 探讨良性腮腺瘤手术中保留耳大神经的可行性.方法 对52例腮腺良性肿瘤患者随机分为保留耳大神经组(A组)32例和不保留耳大神经组(B组)20例,观察两组耳廓感觉障碍程度.结果 术后6个月随访:A组自主感觉恢复28例、针刺感觉恢复27例；B组自主感觉恢复7例、针刺感觉恢复6例；术后1年随访:A组全部病例恢复局部感觉；B组仍有5例未恢复自主感觉、针刺感觉恢复13例.结论 腮腺手术中耳大神经保留是可行的,对减少神经切断后的永久性后遗症,提高患者术后生活质量有积极的意义.

Study on the clinical significance of conserving the greater auricular nerve in parotidectomy of benign parotid tumors

Objective To investigate the feasibility, technique and clinical significance of preserving the great auricular nerve in parotid benign tumors surgery during the first postoperative year. Methods Fifty-two patients with parotid benign tumors were randomly divded into 2 groups. 24 patients （ group sacrificed） underwent classic pa- rotidectomy with sacrifice of the great auricular nerve. The surgeons spare the nerve in the 32 patients with FOCUS ul- trasonic harmonic scalpel （group preserved）. Results After surgery, both groups showed lower levels of subjective sensation and sensory function test at auricle. These alterations were less pronounced in group preserved. Both groups showed improvement over time. In group preserved the sensory function reached normal level by 12 months after sur- gery. The recuperation in group sacrificed was partial at 12 months after operation. Conclusion The great auricular nerve preservation during parotidectomy is feasible. It can decrease sensory disturbance in the early postoperative peri- od and avoid the permanent sequelae that occur when the nerve is sacrificed. The FOCUS ultrasonic harmonic scalpel technique can reduce the operation time.