面神经解剖在腮腺手术中的临床意义

目的：探讨面神经解剖在腮腺肿瘤切除术中的意义。方法：回顾性分析1998～2005年我科施行腮腺肿瘤切除术101例。面神经解剖86例（85.1%，86/101）。面神经总干解剖15例，面神经下颌缘支解剖71例。3例恶性肿瘤和12例小腺瘤未行面神经解剖。腮腺局部切除12例，腮腺浅叶切除74例，腮腺全切除15例。结果：全组术后随访9～33个月，无肿瘤复发病例。4例术后腮腺瘘，7～10d痊愈。1例永久性面瘫。无术后出血、感染等并发症。结论：面神经解剖有助于完整切除腮腺肿瘤和防止面神经医原性损伤。美蓝染色可在术中有效识别面神经。

Clinical signification of facial nerve anatomy in parotid operation

Objective：To study the signification of facial nerve anatomy during parotid operation. Methods：This paper was to summarize and analyze retrospectively the clinical experience of 101 cases with the parotid-tumor who were performed operation from 1998 to 2005. Of these 101 cases, facial nerve were anatomized in 86 cases （85.1%,86/101）,including facial nerve con-caudex anatomy in 15 cases, ramus marginal mandibulae nervous facial anatomy in 71 cases. Malignant tumor in 3 cases and little adenoid tumor in 12 cases weren＇t facial nerve anatomy. Based on demand of the treatment, parotid local excision in 12 cases, parotid superficial-lobe excision in 74 cases and parotid total excision in 15 cases were performed. Results： Followed-up all of patients for 9-33 months, postoperatively, no one recurrence. Fistula of parotid gland occurred in 4 cases and 7-10 days were healed through changing dressing and permanence facial palsy in 1 cases and no post-operative complications such as blooding or infection were observed. Conclusion：It is one of effective measures in parotid oper- ations with facial nerve anatomy for preventing facial nerve iatrogenic damage. Methylene blue is helpful to discriminate facial nerve.