腮腺手术中寻找面神经技巧初探

目的 总结腮腺手术中安全快捷地寻找面神经的方法。方法 回顾分析1994年至2014年西安交通大学第一附属医院耳鼻喉科收治的810例良性腮腺肿瘤或囊肿的病例资料。结果 术中465例采用总干法寻找面神经, 其中11例未找到面神经总干而改用他法, 3例术中损伤面神经总干;138例采用颧支法寻找面神经, 均成功确认神经, 无术中医源性损伤;74例采用下颌缘支法, 均成功确认面神经, 8例术中损伤;133例采用颊支法, 均成功确认神经, 5例术中损伤。结论 腮腺手术中应以固定的解剖标志寻找面神经, 首选总干法及颧支法, 尽量避免下颌缘支法, 但也要根据患者的具体情况采用合适的方法。

Methods for exposure of the facial nerve in parotid gland surgery

Objective To explore the parotid gland surgery in a safe and efficient way to expose the facial nerve. Methods A total of 810 benign parotid gland cases were retrospectively analyzed, they were respectively treated by the methods of total trunk, zygomatic branch, mandibular margin and buccal branch to locate the facial nerve. Results A total of 465 cases were treated by the total tunk method, 11 cases of them were not found with this method and then were found with other methods, and 3 cases of them were injuried the facial nerve trunk; 138 cases were exposured the facial nerve successfully with the zygomatic branch method; 74 cases were exposured successfully with the mandibular margin method, 8 cases of them had intra-operative injury; 133 cases were exposured successfully with the buccal branch method, 5 cases of them had intra-operative injury. Conclusion Parotid gland surgery at a fixed anatomic mark is good at searching the facial nerve. In according to the actual circumstances of the patients, surgeons should use comprehensive methods to expose the facial nerve in a safe and quick way.