口腔修复膜和胸锁乳突肌瓣在腮腺切除术中的应用

目的：分析腮腺切除术中应用口腔修复膜和胸锁乳突肌瓣预防Frey综合征及面部凹陷性畸形的临床疗效。方法：147例患者随机分为3组，治疗1组51例采用口腔修复膜修复腮腺切除术后创面，治疗2组43例采用胸锁乳突肌瓣修复，对照组53例不做任何修复。三组患者术后随访24个月，比较Frey综合征发生率及患者对面容的满意度并进行统计学分析。结果：治疗1组中3例（3．9％）患者有Frey综合征临床表现，21例（41．2％）患者Minor试验阳性；治疗2组有3例（7．0％）发生Frey综合征，19例（44．2％）Minor＇s试验阳性；对照组有23例（43．4％）发生Frev综合征，44例（83．0％）Minor’S试验阳性，比较Minor’s试验阳性率：治疗组与对照组间P〈0．05，治疗组问P〉0．05。面容满意度分为不满意及满意，三组患者满意度调查不满意者分别为13例（25．5％），2例（4．7％），33例（62．3％）；满意者为38例（74．5％），41例（95．3％），20例（37．7％）。三组患者满意度比较：治疗组与对照组间P〈0．05，治疗组间P〈0．05。结论：腮腺切除术后使用口腔修复膜及胸锁乳突肌瓣修复创面可显著降低Frey综合征的发生率，有效地避免面部凹陷畸形，使用胸锁乳突肌瓣对于避免面部凹陷畸形效果更佳。

Application of oral plerosis membrane and sternocleidomastoid muscle flap in parotidectomy.

Objective： TO analyze clinical therapeutic effect of oral plerosis membrane and sternocleidomastoid muscle falp to prevent frey syndrome and facial collapse deformity. Method： Total 147 patients were randomly divided into 3 groups. 51 cases in treatment group 1st were repaired with oral plerosis membraneand.43 cases in treatment group 2nd were repaired with sternocleidomastoid muscle flap.The other 53 cases in control group were not repaired with any material. All cases were followed up during 24 months after operation and were compared with incidence of Frey Syndrome and facial degree of satisfaction to analyze if there was statistical significance. Result： In treatment group 1st 3 cases （3.9 %） appeared clinical manifestation of Frey Syndrome and Minor, s starch-iodine tests of 21 cases （41.2 %） were positive. In treatment 2nd 3 cases （7.0 %） appeared clinical manifestation and Minor, s starch-iodine tests of 19 cases （44.2 %）were positive.And in control group there were 23 （43.4 %） and 44 （83.0 %） .There were significant difference between treatment group （P 〈0.05） to compare with incidence of Frey Syndrome, and not significant difference between treatment group （P 〉0.05）.facial degree of satisfaction was divided into not satisfaction and satisfaction. Not satisfactory cases in 3 groups were 13 （25.5 %）, 2 （4.7 %）, 33 （62.3 %）.Satisfactory cases were respectively 38 （74.5 %）, 41 （95.3 %）, 20 （37.7 %）.There were significant difference between treatment group and control group, and between control groups （P 〈0.05）. Conclusion： Application of oral plerosis membrane and stenocleidomastoid muscle flap in parotidectomy can both reduce incidence of Frey syndrome obviously, and avoid facial collapse deformity efficiently, and sternocleidomastoid muscle flap can do better.