山东大学耳鼻喉眼学报 ›› 2011, Vol. 25 ›› Issue (4): 13-.

• 论文 • 上一篇    下一篇

显微镜下功能性腮腺切除术治疗腮腺良性肿瘤42例

李晨,黄建民,王德生   

  1. 福建医科大学附属协和医院耳鼻咽喉头颈外科, 福州  350001
  • 收稿日期:2011-01-28 修回日期:2011-03-28 出版日期:2011-08-16 发布日期:2011-08-16
  • 作者简介:李晨(1976- ),男,主治医师,主要从事咽喉科学和头颈肿瘤方面的研究。 Email:lc7698999@163.com

Functional excision of 42 benign parotid tumors under a microscope

LI Chen, HUANG Jian-min, WANG De-sheng   

  1. Department of Otolaryngology-Head & Neck Surgery, The Affiliate Union Hospital,  Fujian Medical University, Fuzhou 350001, China
  • Received:2011-01-28 Revised:2011-03-28 Online:2011-08-16 Published:2011-08-16

摘要:

目的        评价显微镜下功能性腮腺切除术治疗腮腺良性肿瘤的临床疗效。方法       采用显微镜下功能性腮腺切除术,治疗腮腺浅叶良性肿瘤患者42例。该术式较传统术式改良之处主要有:全程显微镜下手术直观准确;切口改良、美容;腮腺嚼肌筋膜下翻瓣;解剖保留耳大神经后支和腮腺导管;只解剖暴露面神经的部分分支;包括肿瘤在内的腮腺浅叶部分切除;胸锁乳突肌肌瓣填塞术腔等。结果        42例术后出现面神经损伤3例(7.1%),损伤均为暂时性;出现Frey综合征者1例(2.4%);发生涎瘘者0例;5例(11.9%)患者术后出现不同程度的耳垂和耳郭背部皮肤感觉减弱;术后局部凹陷不明显,患者对颜面部外观满意。术后随访1~5年,未见肿瘤复发。结论       显微镜下功能性腮腺切除术治疗腮腺良性肿瘤,既降低手术并发症发生率,又可取得良好美容效果。

关键词: 腮腺肿瘤;功能性手术;腮腺手术;显微镜

Abstract:

Objective        To evaluate the clinical effectiveness of functional excision of benign parotid tumor under a microscope. Methods        42 patients with benign tumors in the superficial lobe of parotid gland were treated with functional excision under a microscope. Compared with the traditional operation, functional parotidectomy under microscope had several advantages, including direct-view, accurate and cosmetic incision, great preservation of parotid masseter fascia/post aurem of great auricular nerve/the duct of parotid gland, and limited exposure of facial nerves. The tumor can be removed by the partial resection of parotid gland superficial lobes and the skin deformity could be repaired with the sternocleidomastoid muscle flap. Results       Among the 42 cases,3 suffered from transient facial nerve palsy. Frey syndrome was identified in 1 case. 5 patients showed decreased sensation around the auricular lobule and anterior auricular region. There was no salivary fistula after the operation and facial deformity was not obvious. Patients were satisfied with their facial appearance. No re-occurrence was found during 1 to 5 year follow-up. Conclusion      Treating benign parotid tumor by functional parotidectomy under a microscope can not only reduce- postoperative complications, but also achieve an  aesthetic effect.

Key words: Parotid tumor; Functional surgery; Parotid excision; Microscope

中图分类号: 

  • R739.87
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