腮腺肿瘤再手术时面神经的处理

目的探讨腮腺肿瘤再次手术时面神经的处理。方法对近6年来我院收治的36例腮腺肿瘤术后复发，再次手术时面神经的处理方式，进行回顾性分析总结。其中7例有2次以上腮腺肿瘤手术史，有病理记载恶性者9例，有面瘫者5例。结果再手术行腮腺浅叶加肿瘤切除22例，均保留神经。行全腮腺切除14例，其中5例切除面神经。术后病理报告恶性者11例。结论对良性病例术中应保留面神经。对恶性病例，再次手术时对面神经是否保留，不能以肿瘤大小而定，而应根据病理分类、肿瘤与面神经粘连程度而定。恶性病例术后行综合治疗。

The treatment of the facial nerves in the re-operation of the parotid gland tumor

Objective To explore the treatment of the facial nerves in the re-operation of the parotid gland tumor.Methods The treatments of the facial nerves in the re-operation of the parotid gland tumor for the 36 relapsed patients in the last 6 years were viewed retrospectively. Among the 36 patients, 7 have had the parotid tumor operation more than twice, 9 had the pathological report of malignant tumor, 5 suffered from the facial paralysis.Results The nerves were preserved in the 22 re-operation cases of excising the superficial parotid and tumor. The whole parotids were excised in the 14 cases, during 5 of which the facial nerves were resected,11 were malignant tumors.Conclusion The facial nerves should be preserved in the benignancy case. But in the malignant case, which should be treated complexly, whether preserve the facial nerves or not should be decided on the basis of the cases classification, adhesion extent between the tumor and the facial nerves as well as the lymphatic metastasis condition but not on the size of the tumor.