腮腺手术的美容处理

目的：探讨改良切口及胸锁乳突肌瓣在腮腺良性肿瘤手术中应用的美容效果。方法：采用耳前切口向下至耳垂后向后延伸至发际并沿发际边缘延伸的改良切口入路行腮腺区肿瘤及浅叶切除、面神经解剖术,术中尽量保留耳大神经,切取近乳突的部分胸锁乳突肌填塞创腔,随访3-60个月观察术后美容效果和手术预后。行腮腺浅叶肿瘤手术共计28例,男性17例,女性11例。结果：所有患者均达到I期愈合,无涎瘘和感染发生。其中5例术后短期出现轻微口角偏斜,3个月内均恢复正常。所有患者都出现术后耳垂麻木,除耳大神经被切断者4例耳垂麻木症状无改善外,其余24例均于术后3个月后恢复感觉。患者对术后美观程度满意,肿瘤无复发。结论：改良切口用于腮腺浅叶良性肿瘤手术,暴露腮腺及面神经满意,较传统腮腺手术切口隐蔽美观,联合胸锁乳突肌瓣填塞创腔可以取得良好的美容效果。

Aesthetic Treatment on Parotid Tumor Operation

Objective：To investigate the esthetic effect of application of the modified incision and sternocleidomastoid flap in operation on parotid benign tumor.Methods： A modified incision derived from facial plastic surgery was applied to parotidectomy for aesthetic effects and preservation of facial nerve as well as great auricular nerve.After that partial or total parotidecomy and tumorect omy performed,filled the defect with partial sternocleidomastoid near mastoid process.3～60 months follow-up was conducted with focus on the cosmetic effect of this incision and the clinical outcome.28cases（17 males,11 females）with parotid tumor were chosen for the operation.Results： The modified incision healed well in all patients without salivary fistulae and infection.Slight distortion of commissure appeared in 5 cases and recovered in 3 months.all patients complained of earlobe numb after operation,but recovered 3 months postoperatively except for 4 patients whose great auricular nerves were cut off during operation.All the patients were highly satisfied with this modified incision.No recurrence was founded in all patients.Conclusion： Application of esthetic incision and sternocleidomastoid flap in operation of parotid benign tumor can reveal parotid and facial nerve better,and can obtain better appearance compared to traditional incision.