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。

Functional excision of 42 benign parotid tumors under a microscope

Objective To evaluate the clinical effectiveness of functional excision of benign parotid tumor under a microscope. Methods 42 patients with benign tumors in the superficial lobe of parotid gland were treated with functional excision under a microscope. Compared with the traditional operation, functional parotidectomy under microscope had several advantages， including direct-view, accurate and cosmetic incision, great preservation of parotid masseter fascia/post aurem of great auricular nerve/the duct of parotid gland, and limited exposure of facial nerves. The tumor can be removed by the partial resection of parotid gland superficial lobes and the skin deformity could be repaired with the sternocleidomastoid muscle flap. Results Among the 42 cases,3 suffered from transient facial nerve palsy. Frey syndrome was identified in 1 case. 5 patients showed decreased sensation around the auricular lobule and anterior auricular region. There was no salivary fistula after the operation and facial deformity was not obvious. Patients were satisfied with their facial appearance. No re-occurrence was found during 1 to 5 year follow-up. Conclusion Treating benign parotid tumor by functional parotidectomy under a microscope can not only reduce- postoperative complications, but also achieve an aesthetic effect.