程序化功能性腮腺切除术的初步探讨

目的探讨改良腮腺切除术的临床应用。方法从手术切口、耳大神经保留、面神经解剖、区域性腮腺切除、凹陷性畸形整复和端侧神经吻合术的运用等多个方面对腮腺切除术进行改良。结果随访肿瘤均未见复发,无面瘫及明显味觉出汗综合征,耳周的感觉恢复正常,颌面部基本对称,无明显凹陷性畸形,瘢痕隐蔽。结论可根据患者的个性化情况,程序化地采用功能性腮腺切除术。

Preliminary study on programmed functional parotidectomy

Objective Programmed functional parotidectomy is used for treatment of salivary gland diseases to enhance the quality of life and radically cure the tumor.Methods Between 1998 and 2004,23 patients underwent parotidectomies.Parotidectomy was designed and modified as follows: ① Using a facial esthetical incision to avoid the scar in the face and neck;② Preservation of great auricular nerve in parotidectomy;③ Dissection of facial nerve from main trunk to peripheral branches during operation;④ Partial superficial parotidectomy was advocated according to the size and character of the tumor;⑤Terminolateral neurorrhaphy was taken to repair the defect of facial nerve injured in operation;⑥ Repairing sunken deformity with an upper pedicle sternocleidomastoid muscle flap after parotidectomy.Results No recurrence was found in follow-ups.All patients showed good results with no obvious scar and sunken deformity left in face and submandibular region.No remarkable facial paralysis was found 6 months after operation.Almost all the patients have no complaints about Frey's syndrome.Conclusion Programmed functional parotidectomy has great advantages in reducing the complication and rehabilitating the facial function.