改良式腮腺良性肿瘤切除术36例

目的: 介绍一种改良手术切除腮腺良性肿瘤的方法。方法: 采用隐蔽的面部除皱切口,清晰解剖并保留耳大神经后支;根据肿瘤位置,选择性逆行解剖面神经周围支,行保留腮腺主导管的腮腺浅叶部分切除术;胸锁乳突肌瓣充填术区缺损,并作为阻断副交感神经与节后交感神经纤维互相吻合的屏障;术后放置负压引流管。结果: 36例均顺利完成手术,出现暂时性面神经功能减弱者5例,随访1~3年无复发;无一例发生Frey综合征及涎漏,术后耳垂感觉完全恢复,残留腮腺功能保留良好,美容效果满意率100%。结论: 改良的腮腺切除术,克服了传统术式的缺憾,降低了术后并发症发生率,值得临床推广。

Technical refinements in the surgical treatment of benign parotid tumors

Objective: To describe a modified technique of benign parotid tumors. Methods: Using a face-life incision, the greater auricular nerve was exposed and repaired. According to the position of the tumor, the facial nerve surrounding the branch was selectively retrograded and anatomized, and a partial ectomy of the superficial part of the parotid gland main catheter was performed, keeping the parotid gland. A sternocleidomastoid flap is then transplanted to fill the surgical defect and block the anastomosis between the fibers of the parasympathetic nerve and sympathetic nerve as a mechanical barrier, using the suction drain postoperatively. Results: Thirty-six patients received modified parotidectomy, and all operations were successful. Temporary moderate facial palsy occurred in 5 patients. All patients were followed up for 1-3 years;none of them developed Frey's syndrome or salivary fistula. Further, earlobe sensation recovered completely. The function of the rest of the parotid gland was maintained, and all patients had a satisfactory opinion of their post-operation cosmetic appearance. Conclusions: A modified parotidectomy technique greatly reduces the disadvantages of traditional parotidectomy techniques. A long-term follow-up is needed before the technique can be used as a conventional technique.