山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 48-50.doi: 10.6040/j.issn.1673-3770.0.2015.028

• 论著 • 上一篇    下一篇

腮腺手术中寻找面神经技巧初探

王晓侠1,2, 姚小宝1, 李宏慧1, 白艳霞1, 张少强1, 申震1, 李白芽1   

  1. 1. 西安交通大学第一附属医院耳鼻喉科, 陕西 西安 710061;
    2. 解放军第451医院耳鼻喉科, 陕西 西安 710054
  • 收稿日期:2015-01-11 修回日期:2015-06-11 出版日期:2015-08-16 发布日期:2015-08-16
  • 通讯作者: 姚小宝。E-mail:yaoxiaobao@sohu.com E-mail:yaoxiaobao@sohu.com
  • 作者简介:王晓侠。E-mail:xiaoxiawang9139@sina.com

Methods for exposure of the facial nerve in parotid gland surgery.

WANG Xiaoxia1,2, YAO Xiaobao1, LI Honghui1, BAI Yanxia1, ZHANG Shaoqiang1, SHEN Zhen1, LI Baiya1   

  1. 1. Department of Otolaryngology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China;
    2. Department of Otolaryngology, the 451 st Hospital of Chinese PLA, Xi'an 710054, Shaanxi, China
  • Received:2015-01-11 Revised:2015-06-11 Online:2015-08-16 Published:2015-08-16

摘要: 目的 总结腮腺手术中安全快捷地寻找面神经的方法。方法 回顾分析1994年至2014年西安交通大学第一附属医院耳鼻喉科收治的810例良性腮腺肿瘤或囊肿的病例资料。结果 术中465例采用总干法寻找面神经, 其中11例未找到面神经总干而改用他法, 3例术中损伤面神经总干;138例采用颧支法寻找面神经, 均成功确认神经, 无术中医源性损伤;74例采用下颌缘支法, 均成功确认面神经, 8例术中损伤;133例采用颊支法, 均成功确认神经, 5例术中损伤。结论 腮腺手术中应以固定的解剖标志寻找面神经, 首选总干法及颧支法, 尽量避免下颌缘支法, 但也要根据患者的具体情况采用合适的方法。

关键词: 腮腺切除术, 面神经, 外科手术

Abstract: Objective To explore the parotid gland surgery in a safe and efficient way to expose the facial nerve. Methods A total of 810 benign parotid gland cases were retrospectively analyzed, they were respectively treated by the methods of total trunk, zygomatic branch, mandibular margin and buccal branch to locate the facial nerve. Results A total of 465 cases were treated by the total tunk method, 11 cases of them were not found with this method and then were found with other methods, and 3 cases of them were injuried the facial nerve trunk; 138 cases were exposured the facial nerve successfully with the zygomatic branch method; 74 cases were exposured successfully with the mandibular margin method, 8 cases of them had intra-operative injury; 133 cases were exposured successfully with the buccal branch method, 5 cases of them had intra-operative injury. Conclusion Parotid gland surgery at a fixed anatomic mark is good at searching the facial nerve. In according to the actual circumstances of the patients, surgeons should use comprehensive methods to expose the facial nerve in a safe and quick way.

Key words: Surgical procedures, operative, Parotid neoplasms, Facial nerve

中图分类号: 

  • R748
[1] 郭传瑸,俞光岩,毛驰,等.腮腺肿瘤手术入路的选择[J].中华耳鼻咽喉头颈外科杂志,2005,40(5):396-398. GUO Chuangbin, YU Guangyan, MAO Chi, et al. Different approaches via tumors of the parotid gland[J]. Clin J Otolaryngol Head Neck Surg, 2005, 40(5):396-398.
[2] 王怀经.局部解剖学[M].北京:人民卫生出版社,2005:10-11.
[3] 张程,张卫国,张鹏,等.面神经主干的应用解剖学研究[J].山西医科大学学报,2013,44(7):511-514. ZHANG Cheng, ZHANG Weiguo, ZHANG Peng, et al. Applied anatomical study on the facial nerve trunk[J]. J Shanxi Med Univ, 2013, 44(7):511-514.
[4] 曹钟义,钱永,张绚,等.腮腺手术中面神经解剖术式与面神经功能损伤的临床研究[J].实用口腔医学杂志,2012,28(5):630-632. CAO Zhongyi, QIAN Yong, ZHANG Xun, et al. A clinical study of facial nerve dissection and functional injury in parotidectomy[J]. J Pract Stom, 2012, 28(5):630-632.
[5] Babademez M A, Acar B, Gunbey E, et al. Anomalous relationship of the retromandibular vein to the facial nerve as a potential risk factor for facial nerve injury during parotidectomy[J]. J Craniofac Surg, 2010, 21(3):801-802.
[6] 张大为.颌后静脉为标志寻找和保护面神经的意义[J].医学美学美容,2014,3(2):303. ZHANG Dawei. Anatomy and protection of the facial nerve by Jaw after intravenous[J]. Med Aesth Cosmetol, 2014, 3(2):303.
[7] 吴文艺,张丽婷.沿下颌缘支逆向解剖面神经在腮腺肿瘤手术中的临床意义[J].中国临床解剖学杂志,2012,30(4):466-468. WU Wenyi, ZHANG Liting. The clinical significance of along the mandibular margin of the reverse the anatomy of the facial nerve in parotid neoplasms[J]. Chin J Clin Anat, 2012, 30(4):466-468.
[8] 王志斌.以颞浅动脉定位颞支的面神经解剖方法[J].中国伤残医学,2013,2l(7):154-155. WANG Zhibin. With superficial temporoparietal positioning the temporal branch of the facial nerve dissection method[J]. Chin J Trauma Disab Med, 2013, 21(7):154-155.
[9] 刘安堂.面神经颊支和下颌缘支的解剖及临床应用研究进展[J].中国临床解剖学杂志,2007,25(1):106-108. LIU Antang. Buccal and marginal mandibular branches of facial nerve: the anatomy and clinical significance[J]. Chin J Clin Anat, 2007, 25(1):106-108.
[10] 李明,朱志军.解剖面神经颧支在腮腺切除术中的临床应用[J]. 临床口腔医学杂志,2011,27(4) :238-239. LI Ming, ZHU Zhijun. Anatomy of zygomatic branch of facial never in parotidectomy[J]. J Clin Stomatol, 2011, 27(4) :238-239.
[11] 廖建春.腮腺手术的应用解剖与临床[J].中华解剖与临床杂志,2014,19(1):82-85. LIAO Jianchun. Applied anatomy and clinical parotid gland surgery[J]. Chin J Anat Clin, 2014, 19(1):82-85.
[1] 高娟娟,许嘉,陈雯婧,梁思超,郭振平,陈俊言,郭翔,伊海金. 保留面神经功能的面神经鞘瘤次全切除手术治疗[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 8-16.
[2] 陈涛,姜洋,李莹. SMILE矫正PRK术后屈光回退1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 148-153.
[3] 彭薪燃,李永团. Madelung病伴阴囊脂肪堆积1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 67-71.
[4] 翟贯虹,于司函,张志强,于常旭,崔哲洙. 中耳胆脂瘤合并面瘫的手术后疗效分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 20-25.
[5] 温立婷,李旭,高伟,胡田勇,曾宪海,查定军. 17例中耳术后迟发性面瘫的临床特征分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 1-5.
[6] 陈世琴,卫平存,胡云龙,胡金旺. 糖皮质激素三种不同鼻用法对鼻内镜术后黏膜转归的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 195-201.
[7] 赵笑冰,张大为,陈仁杰. 中耳间变性大T细胞淋巴瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 7-14.
[8] 马宁, 陈敏, 刘薇, 杨扬, 邵剑波, 郝津生, 刘冰, 张晓, 段晓岷, 张祺丰, 张杰. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19.
[9] 党攀红, 张睿, 胡春燕, 王洁, 樊孟耘. 儿童乳突-颞下迷路外面神经减压术8例临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 37-42.
[10] 赵雅铭,石崧. 以急性会厌炎为首诊的3例颈部坏死性筋膜炎病例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 12-16.
[11] 石玉琦,佘翠平,张庆丰,刘得龙,焦梦思. 早期声门型喉癌低温等离子射频术后喉部感染诊治经验与教训[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 129-134.
[12] 朱华明,关建,茆松,张维天,易红良. 低温等离子射频消融辅助咽旁间隙良性肿瘤切除的应用分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 28-33.
[13] 郭芳,张德军,傅则名,郭颖媛,万怡宁,管国芳. 外耳道胆脂瘤并发化脓性腮腺炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 12-15.
[14] 许嘉,伊海金. 正确处理颞骨骨折耳科并发症[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 4-8.
[15] 王智立,陈哲,林芳羽,柴永川,汪照炎. 修复治疗不同情形下腮腺区面神经损伤[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 15-19.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!