腮腺切除术的手术径路改良

目的 设计一种改良的腮腺切除术的手术径路,旨在改善术后的外形与功能。方法 10例患者采用了该改良手术径路,切口上端起自发际内沿耳屏前,沿纵向皮纹切开,绕过耳垂向后沿耳背后延至乳突根部的发际内。行腮腺全切术3例,腮腺浅叶切除术7例。结果 改良术手术切口,术野暴露清楚,所有病例均将肿瘤完整切除。经1－12个月随访,疗效满意。术后手术切口区基本见不到疤痕。无1例出现永久性面瘫。手术时间和采用“S”切口的手术时间无统计学意义（P＞0．1）。结论 该手术径路,能充分暴露并完整切除腮腺及肿瘤,术后有较满意的面部外形,提高了患者的生存质量。

A Modified surgical Approach of Parotidectomy

Objective It is based on anatomic characteristics of maxillofacial area and parotid, a modified surgical approach of parotidectomy is designed to improve both post operative contour and function.Methods There are 10 cases underwent parotidectomy on this modified approach in which the excision line is coming the hair boundary of the temple and in the mastoid region. Among these cases, 3 patients received complete parotidectomy and 7 patients received superficial lobectomy. Results Satisfied result was acquired at fellow-up from one month to twelve months. All surgical margins were clear in all cases. All patients with the modified incision showed great satisfaction with a postoperative scar which was inconscious and hidden behind the ear and hairline . No permanent paralysised in all patients. The no difference in mean time of surgery between the modified incision and common "S" incision( P > 0.1 ).Conclusion It provides adequate exposure for a total parotidectomy and tumor dissection, it can provide satisfing contour and function. The authors think this new approach can be spread.