面神经三种解剖方法的比较研究

目的:通过比较腮腺肿物手术中3种不同的面神经逆行解剖方法,探讨通过颈支逆行解剖面神经的可行性。方法:腮腺区肿物患者83例,依据肿瘤部位及性质分别采取面神经颈支、下颌缘支和颊支的逆行解剖方法。随访时间6个月至2年,观察治疗效果。结果:面神经颈支逆行解剖组术后面瘫发生率(10.7%)明显低于下颌缘支组(37.1%)和颊支组(45.0%)。三组术式肿瘤复发率无明显差别。结论:面神经颈支逆行解剖法可有效降低面瘫的发生,并能保留颈阔肌功能,有一定的临床应用价值。

A Comparative Study of Three Methods of Facial Nerve Contrary Dissection in Parotid Gland Surgery

Objective: To analyze clinically three methods of facial nerve dissection in parotid gland tumors for improving treatment outcomes. Methods: There were 83 cases of parotid gland tumor. The technique of regional excision including normal salivary gland tissue around the tumor and superfacial parotidectomy were performed, with facial nerve reserved in all cases. In facial nerve dissection, cervicalbranches, marginal mandibular branches and buccal branches were seek respectively. Follow-up was carried out from 6 months to 2 years, with an average period of 15 months. Results: The rates of postoperative facial paralysis were distinctly difference with the incidence being 10.7%,37.1% and 45.0% respectively. There was no difference on relapse among three groups. Conclusion: The rate of postoperative facial paralysis was reduced in the new technique. The surgical approach can achieve a relatively good result in treatment of the parotid gland tumor.