舌下腺囊肿456例临床病理分析

目的：对舌下腺囊肿临床病理资料进行回顾性研究，评价手术方式与疗效的关系，分析并发症的原因。方法：在全麻或局麻下经口内进路或颌下进路或口内联合颌下进路行舌下腺及囊肿摘除术，部分患者行袋形缝合术；术后标本行组织病理观察。结果：312例舌下型舌下腺囊肿经口内行舌下腺及囊肿摘除术，13例复发，复发率为4．17％；6例行袋形缝合术，5例复发，复发率为83．33％；108例口外型分别经口内、颌下进路行舌下腺及囊肿摘除术，其复发率各为1.43％、56％；而经颌下联合口内进路治疗的病例无复发；40例混合型经口内施术，治愈率达100％。包括术后复发，共有57例发生术中术后并发症。病理切片镜下观，447例中257例(57．5％)囊肿有纤维囊壁，但只有5例有部分上皮衬里，190例(42．5％)无明显囊壁。结论：舌下腺囊肿的囊壁无上皮衬里，完整摘除舌下腺是治愈的关键。

Cliniopathologic Study of 456 Cases of Sublingual Gland Cyst

Objectives: To evaluate the relationship between therapic effect and operation methods of sublingual gland cyst , and to analyze the causes of postoperative complication. Methods: 456 cases of sublingual gland cyst were treated with through internal or external surgical approach under general and local anesthesia. Specimens were examined under the light micro-cope. Results: Among 318 intro-oral swelling 312 were treated with resection of the sublingual gland and cyst by intro-oral approach, and the recurrence rate was 4.17%. The other 6 had marsupialization and the recurrence rate was 83.33%. Among 108 cases of plunging ranula 70 cases were treated by internal and external approach , 25 cases by extra-oral approach and 13 cases by intro-extra-oral approach. The recurrence rates were 1.43%. 56% and 0 respectively. Forty patients with oral and external swelling were treatment by excision of the sublingual gland, and no recurrence occurred postoperatively. There were 57 cases of complications associated with the operation. Among 447 cases 257(57.5%) had cyst walls but only 5 had partial epithelial lining. Conclusions: The sublingual cysts have no epithelial lining. The key of treatment of sublingual gland cyst is the removal of sublingual gland.