内窥镜辅助耳后小切口腮腺良性肿瘤切除术的临床应用

目的:探讨内窥镜辅助下小切口行腮腺良性肿瘤切除术的临床价值及相关技术.方法:选取2009年4月至2014年10月于我院住院治疗腮腺肿瘤的患者78例,分为实验组与对照组两组.实验组应用改良耳垂、乳突后小"C"隐蔽切口入路,借助内窥镜在腮腺咬肌筋膜下分离建腔,找到面神经主干,根据肿瘤位置解剖相应分支,行肿瘤及区域性腮腺切除;对照组采用传统术式.通过比较两组的手术时间、术中出血量、切口长度、住院时长、术后引流量、术后并发症以及患者术后满意度来评价内窥镜辅助小切口入路腮腺良性肿瘤切除术的临床应用价值.结果:实验组患者的手术时间和住院时间明显缩短,与对照组比较差异有统计学意义(P<0.05);实验组术中出血量和术后引流量明显减少,与对照组比较差异有统计学意义(P<0.05);实验组手术切口长度明显变短,与对照组比较差异有统计学意义(P<0.05).术后随访结果显示,实验组与对照组患者的口干、凹陷畸形、Frey综合征、暂时性面瘫以及术区麻木等并发症比较,差异均有统计学意义(P<0.05).两组患者对术后面部外观的满意度,实验组明显高于对照组,差异有统计学意义(P<0.05).结论:应用内窥镜辅助下耳后小切口径路行腮腺良性肿瘤切除术安全可行、切口小、瘢痕隐蔽,达到了微创美容效果,且并发症少,值得在临床上大力推广.

Clinical application on minimally invasive endoscopy assisted ear benign parotid tumor resection

Objective:To explore the clinical value and related technologies of minimally invasive endoscopy assis-ted ear benign parotid tumor resection.Methods:78 patients with parotid tumor treated in our hospital from April 2009 to October 2014 were analyzed.They were divided into two groups,namely experimental and control group.Ex-perimental group:Application of modified lobe,mastoid small " C" hidden incision for the road,with the endoscopy the separation chamber built under parotid gland bite fascia,found facial nerve trunk,dissected the corresponding branch according to the anatomical location of the tumor,underwent tumor and regional parotid resection.Control group re-ceived conventional surgery.By comparing the two groups of operative time,blood loss,incision length,length of hospi-tal stay,postoperative drainage,postoperative complications,and evaluated patient satisfaction after a small incision endoscopic resection of benign parotid application value was evaluated.Results:The study demonstrated that the oper-ation time and hospital stay time were significantly shorter in patients in the experimental group compared with the control group,the difference was statistically significant (P< 0.05).In experimental group,blood loss and postopera-tive drainage were significantly reduced compared with the control group,and the difference was statistically significant (P< 0.05).The experimental group had significantly shorter incision length.Compared with the control group,the difference was statistically significant (P< 0.05).Postoperative follow-up results showed dry mouth,deformity,Frey's syndrome,a temporary facial paralysis and numbness surgery area,were statistically significant between the two groups (P< 0.05).In postoperative facial appearance of satisfaction,and the experimental group was significantly higher, and the difference was statistically significant (P< 0 .05 ).Conclusion:The application of endoscopic assistedminimally invasive endoscopic ear benign parotid resection is safe,feasible,with small incision,hidden scar,minimally invasive cosmetics,and fewer complications,and is worthy of clinical popularization.