腮腺区静脉畸形翻瓣激光术的操作探讨

目的:探讨翻瓣Nd:YAG激光术处理腮腺区静脉畸形时的外科操作难点及注意事项。方法:回顾总结近3a来临床诊治的84例患者,全部确诊为腮腺区静脉畸形。均采用全麻下翻瓣激光治疗,手术前后CT、MRI等影像学检查。术后作面神经评判,术中统计出血量。结果:84例患者中,有5例为暂时性面瘫,2个月后自主恢复。1例为永久性面瘫,占1.19%,平均失血约为200ml。4例接受术中、术后输血。结论:腮腺区静脉畸形翻瓣激光术中,只要注意精细解剖操作,合理运用激光照射方式,可获得保存面神经,减少出血的理想效果。

Discussion of surgical laser manipulation of venous malformations in the parotid gland region

PURPOSE: This study is carried to explore the surgical manipulation and complications of Nd:YAG laser coagulation for venous malformations in parotid gland region. METHODS: The study included 84 cases of venous malformations in the parotid gland region, who underwent laser therapy after surgical approach three years ago. The results were evaluated by CT or MRI. Postoperative facial nerve function and intraoperative bleeding were analyzed. RESULTS: Five cases had temporary facial nerve paralysis, which recovered spontaneously two months postoperatively. One case developed permanent nerve paralysis, which accounted for 1.19% in this group. The mean amount of blood loss was 200 ml. Four cases received blood transfusion. CONCLUSION: Careful surgical dissection and correct laser irradiation is the key to successful treatment, which could preserve facial nerve from injury and decrease bleeding.