胸锁乳突肌瓣和腮腺筋膜瓣联合应用对腮腺良性肿瘤术后并发症的预防作用

目的：探讨胸锁乳突肌瓣和腮腺筋膜瓣在腮腺良性肿瘤手术中的临床应用效果。方法：216例腮腺良性肿瘤患者被随机分为对照组和3组试验组,对照组病例在切除腮腺肿瘤后直接关闭手术创面;胸锁乳突肌瓣组则转移带蒂胸锁乳突肌瓣充填术区凹陷;腮腺筋膜瓣组为保留腮腺筋膜瓣用以覆盖手术创面;胸锁乳突肌瓣＋腮腺筋膜瓣组采用先转移带蒂胸锁乳突肌瓣充填术区凹陷,再以保留的腮腺筋膜瓣覆盖手术创面。病例随访6～60个月。结果：胸锁乳突肌瓣＋腮腺筋膜瓣组和胸锁乳突肌瓣组在手术区域凹陷畸形的改善效果优于腮腺筋膜瓣组和对照组（P〈0.01）;而腮腺筋膜瓣组和胸锁乳突肌瓣＋腮腺筋膜瓣组在减少Frey综合征发生方面强于对照组和胸锁乳突肌瓣组（P〈0.01）;对照组与试验组患者在涎瘘发生的差异无统计学意义。结论：胸锁乳突肌瓣可作为修复腮腺术后凹陷缺损的优先选择,腮腺筋膜瓣在降低味觉出汗综合征发生率方面的作用突出,二者的结合应用疗效更为理想。

Application of Sternocleidomastoid Muscle Flap and Parotid Fascia Flap in Operation on Parotid Benign Tumor

Objective： To investigate the application of sternocleidomastoid muscle flap and parotid fascia flap in operation on parotid benign tumor.Methods： 216 cases with parotid benign tumors were randomly divided into 1 control group and 3 experimental groups.The patients in control group were treated with traditional parotidectomy,while the patients in experimental groups were treated with modified parotidectomy including repairng the soft tissue defects by sternocleidomastoid muscle flap and parotid fascia flap.Results： There were significant lower rates on sunken deformities and Frey＇s syndrome in experimental groups than that of control group（P0.01）.The effects of sternocleidomastoid muscle flap combined with parotid fascia flap were better.Conclusion： The sternocleidomastoid muscle flap and parotid fascia flap transfer can obviously improve post-operative deformity and prevent the incidence of Frey＇s syndrome.