山东大学耳鼻喉眼学报 ›› 2026, Vol. 40 ›› Issue (2): 1-6.doi: 10.6040/j.issn.1673-3770.0.2024.537

• 论著 •    下一篇

耳后沟切口联合腮腺下极瓣修复在腮腺浅叶良性肿瘤手术中的应用

许亚琳1,陈庆泳2,王冬青3,林立强3,陈志鹏3,吕怀庆3   

  1. 1.山东第二医科大学 临床医学院, 山东 潍坊 261053;
    2.滨州医学院 第二临床医学院, 山东 烟台 264003;
    3.临沂市人民医院 耳鼻咽喉头颈外科, 山东 临沂 276003;
  • 发布日期:2026-03-26
  • 通讯作者: 吕怀庆. E-mail:lvhuaiqing@126.com

Application of retroauricular incision combined with subparotid flap repair in surgery for benign tumors of the superficial parotid lobe

XU Yalin1, CHEN Qingyong2, WANG Dongqing3, LIN Liqiang3, CHEN Zhipeng3, LYU Huaiqing3   

  1. 1. School of Clinical Medicine, Shandong Second Medical University, Weifang 261053, Shandong, China2. The Second Clinical Medical College, Binzhou Medical University, Yantai 264003, Shandong, China3. Department of Otorhinolaryngology & Head and Neck Surgery, Linyi People's Hospital, Linyi 276003, Shandong, China
  • Published:2026-03-26

摘要: 目的 探讨耳后沟切口联合腮腺下极瓣修复术治疗腮腺浅叶良性肿瘤的疗效。 方法 采用耳后沟切口,对26例腮腺浅叶良性肿瘤患者行腮腺浅叶部分切除、面神经解剖及腮腺下极瓣转移修复术,观察和评估术后疗效。 结果 术后25例患者达到Ⅰ期愈合,1例患者出现涎漏,术后17 d完全愈合。经1~5年随访,所有患者未出现腮腺区凹陷畸形,正面及侧面无可见瘢痕,无肿瘤复发,无永久性面神经麻痹,无Frey综合征出现。 结论 耳后沟切口联合腮腺下极瓣转移修复术可有效减少腮腺浅叶良性肿瘤术后局部凹陷畸形,具有切口隐蔽、美容效果好、并发症少等优点。

关键词: 腮腺下极瓣, 耳后沟切口, 腮腺肿瘤, 美容

中图分类号: 

  • R782.2
[1] 张志愿. 口腔颌面外科学[M]. 8版. 北京: 人民卫生出版社, 2020: 220-223
[2] Patey DH, Thackray AC. The treatment of parotid tumours in the light of a pathological study of parotidectomy material[J]. Br J Surg, 2010, 45(193): 477-487. doi:10.1002/bjs.18004519314
[3] Nouraei SAR, C. Al-Yaghchi, Ahmed J, et al. An anatomical comparison of Blair and facelift incisions for parotid surgery[J]. Clinical Otolaryngology, 2006, 31(6). doi:10.1111/j.1365-2273.2006.01334.x
[4] 潘朝斌, 林钊宇. 腮腺良性肿瘤诊断、手术方式及常见并发症的预防与处理[J]. 口腔疾病防治, 2022, 30(11):8. doi:10.12016/j.issn.2096-1456.2022.11.001 PAN Chaobin, LIN Zhaoyu. Diagnosis and surgical approach of parotid gland benign tumors and treatment of common complications[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2022, 30(11): 761-768. doi:10.12016/j.issn.2096-1456.2022.11.001
[5] Ruohoalho J, Mäkitie AA, Aro K, et al. Complications after surgery for benign parotid gland neoplasms: a prospective cohort study[J]. Head Neck, 2017, 39(1): 170-176. doi:10.1002/hed.24496
[6] Lee HY, Park MS, Byun JY, et al. Agreement between the Facial Nerve Grading System 2.0 and the House-Brackmann Grading System in Patients with Bell Palsy[J]. Clinical & Experimental Otorhinolaryngology, 2013, 6(3):135-139. doi:10.3342/ceo.2013.6.3.135
[7] Katz MR, Irish JC, Devins GM, et al. Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients[J]. Head & Neck, 2015, 22(2): 132-141. doi:10.1002/(SICI)1097-0347(200003)22:2<132:AID-HED4>3.0.CO;2-K
[8] Bulut OC, Plinkert P, Federspil PA. Modified facelift incision for partial parotidectomy versus bayonet-shaped incision: a comparison using visual analog scale[J]. Eur Arch Otorhinolaryngol, 2016, 273(10): 3269-3275. doi:10.1007/s00405-015-3878-0
[9] Motz KM, Kim YJ. Auriculotemporal Syndrome(Frey Syndrome)[J]. Otolaryngol Clin North Am, 2016, 49(2): 501-509. doi: 10.1016/j.otc.2015.10.010
[10] Jost G, Guenon P, Gentil S. Parotidectomy: a plastic approach[J]. Aesthetic Plast Surg, 1999, 23(1): 1-4. doi:10.1007/s002669900234
[11] 聂廷洪, 张碧荷, 高丽荣. 腮腺良性肿瘤术式及切口选择研究进展[J]. 医学理论与实践, 2024, 37(6): 928-931. doi:10.19381/j.issn.1001-7585.2024.06.008 NIE Tinghong, ZHANG Bihe, GAO Lirong. Research progress on surgical methods and incision selection of parotid benign tumors[J]. The Journal of Medical Theory and Practice, 2024, 37(6): 928-931. doi:10.19381/j.issn.1001-7585.2024.06.008
[12] 吴平凡, 陈林林, 陈芬, 等. 耳后隐蔽切口入路切除腮腺下极良性肿瘤疗效评价[J]. 口腔疾病防治, 2020, 28(12): 781-784. doi: 10.12016/j.issn.2096-1456.2020.12.005 WU Pingfan, CHEN Linlin, CHEN Fen, et al. Removal of benign tumor in the lower pole of the parotid gland through concealed incision in the retroauricular sulcus [J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(12): 781-784. doi: 10.12016/j.issn.2096-1456.2020.12.005
[13] 王云辉, 张廷功, 陈志鹏, 等. 耳后沟切口在腮腺肿瘤手术中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(9): 855-857. doi: 10.3760/cma.j.cn115330-20200221-00109 WANG Yunhui, ZHANG Tinggong, CHEN Zhipeng, et al. Application of retroauricular sulcus incision in surgery of parotid gland tumor[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 55(9): 855-857. doi: 10.3760/cma.j.cn115330-20200221-00109
[14] 曾宪平, 李娟, 汤苏成, 等. 胸锁乳突肌瓣修复改善腮腺术后外观畸形[J]. 中国临床解剖学杂志, 2022, 40(1): 81-84. doi:10.13418/j.issn.1001-165x.2022.1.16. ZENG Xianping, LI Juan, TANG Sucheng, et al. Sternocleidomastoid muscle flaps reconstruction to improve the facial deformity of parotidectomy [J]. Chinese Journal of Clinical Anatomy, 2022, 40(1): 81-84. doi: 10.13418/j.i SSN. 1001-165-x. 2022.1.16
[15] Fawzy A, Balbaa MA, Hagag M. Evaluation of functional and aesthetic outcomes of free dermal fat graft versus superficial musculoaponeurotic system flap after superficial parotidectomy: randomized clinical trial[J]. BJS Open, 2023, 7(3): zrac173. doi:10.1093/bjsopen/zrac173
[16] 黄谢山. 耳后肌骨膜瓣在腮腺肿瘤切除手术应用的临床研究[D]. 长沙: 中南大学, 2012: 3-14
[17] Movassaghi K, Lewis M, Shahzad F, et al. Optimizing the aesthetic result of parotidectomy with a facelift incision and temporoparietal Fascia flap[J]. Plast Reconstr Surg Glob Open, 2019, 7(2): 2067. doi:10.1097/GOX.0000000000002067
[18] Vitkos EN, Kounatidou NE, Tsilivigkos C, et al. Restoring form and function: the role of free dermal fat graft(FDFG)in post-parotidectomy reconstruction. A systematic review and meta-analysis of expected outcomes and patient satisfaction[J]. J Stomatol Oral Maxillofac Surg, 2025, 126(6): 102162. doi:10.1016/j.jormas.2024.102162
[19] Chai XD, Jiang H, Tang LL, et al. Factors influencing Frey syndrome after parotidectomy with acellular dermal matrix[J]. World J Clin Cases, 2024, 12(9): 1578-1584. doi:10.12998/wjcc.v12.i9.1578
[20] 张凯, 李春明. 腮腺肿瘤术后面部畸形与Frey综合征综合防治的研究进展[J]. 口腔医学研究, 2019, 35(1): 20-22. doi:10.13701/j.cnki.kqyxyj.2019.01.005 ZHANG Kai, LI Chunming. Research progress on comprehensive prevention and treatment of facial malformation and frey syndrome after parotid neoplasms [J]. Journal of Oral Science Research, 2019, 35(1): 20-22. doi: 10.13701 / j.carol carroll nki kqyxyj. 2019.01.005
[21] Zenke J, Alenazi A, Sommerfeld C, et al. Long-term results of a pedicled and innervated sternocleidomastoid muscle flap to immediately reconstruct superficial parotidectomy defects[J]. Facial Plast Surg Aesthet Med, 2020, 22(6): 420-426. doi:10.1089/fpsam.2020.0073
[22] Jain A, Rai A. Meta-analysis to evaluate the efficacy of sternocleidomastoid muscle flap as a reconstruction modality in prevention of Frey's syndrome following parotidectomy[J]. J Maxillofac Oral Surg, 2021, 20(2): 310-318. doi:10.1007/s12663-020-01380-5
[23] 姜平, 钟世镇, 徐达传. 面部表浅肌肉腱膜系统(SMAS)的解剖学研究[J].中国临床解剖学杂志,1999,(4): 320-322. doi:10.13418/j.issn.1001-165x.1999.04.020 JIANG Ping, ZHONG Shizhen, XU Dachuan. An anatomic study on the superficial musculoaponeurotic system(SMAS)in the face[J]. Chinese Journal of Clinical Anatomy, 1999,(4): 320-322. doi:10.13418/j.issn.1001-165x.1999.04.020
[24] Ambro BT, Goodstein LA, Morales RE, et al. Evaluation of superficial musculoaponeurotic system flap and fat graft outcomes for benign and malignant parotid disease[J]. Otolaryngol Head Neck Surg, 2013, 148(6): 949-954. doi:10.1177/0194599812474969
[25] 曹春雷, 张红闯, 万延俊, 等. SMAS及胸锁乳突肌瓣在腮腺肿瘤外科中的应用[J]. 口腔医学, 2013, 33(1): 27-29. doi:10.13591/j.cnki.kqyx.2013.01.005 CAO Chunlei, ZHANG Hongchuang, WAN Yanjun, et al. The application of SMAS and sternocleidomastoid muscle flap in parotid gland tumor ectomy[J]. Stomatology, 2013, 33(1): 27-29.doi:10.13591/j.cnki.kqyx.2013.01.005
[26] 余海, 刘德裕, 李传真, 等. 耳后肌筋膜骨膜瓣及改良除皱切口在腮腺手术中的应用[J]. 中国修复重建外科杂志, 2009, 23(10): 1167-1169 YU Hai, LIU Deyu, LI Chuanzhen, et al. Clinical application of postauricular muscular fasciae-periosteal flap and modified unwrinkle incision in parotidectomy[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2009, 23(10): 1167-1169
[27] 马洪峰, 任庆. 异种脱细胞真皮基质的临床研究进展[J]. 齐齐哈尔医学院学报, 2023, 44(6): 573-576. doi: 10.3969/j.issn.1002-1256.2023.06.017 MA Hongfeng, REN Qing. Research progress on clinical study of Xenogenic AcelluIar Dermal Matrix[J]. Journal of Qiqihar Medical College College, 2023,44(6):573-576. doi: 10.3969/j.issn.1002-1256.2023.06.017
[28] 颜光堂, 王中亮, 田蓉, 等. 异种脱细胞真皮基质组织补片置入对腮腺良性肿瘤患者术后味觉出汗综合征发生的影响[J]. 保健医学研究与实践, 2024, 21(4): 49-54. doi: 10.11986/j.issn.1673-873X.2024.04.009 YAN Guangtang, WANG Zhongliang, TIAN Rong, et al. Effects of heterogeneous acellular dermal matrix implantation on gustatory sweating syndrome in patients with benign parotid tumors[J]. Health Medicine Research and Practice, 2024, 21(4): 49-54. doi: 10.11986/j.issn.1673-873X.2024.04.009
[29] 朱守莉, 马新亮, 韩立显, 等. 胸锁乳突肌瓣联合异种脱细胞真皮基质预防味觉出汗综合征[J]. 广东牙病防治, 2014, 22(7): 355-358 ZHU Shouli, MA Xinliang, HAN Lixian, et al. Using of Sternocleidomastoid flap combined with acellular dermal matrix to prevent Frey's syndrome[J]. Journal of Dental Prevention and Treatment, 2014, 22(7): 355-358
[30] De Virgilio A, Costantino A, Russo E, et al. Different surgical strategies in the prevention of Frey syndrome: a systematic review and meta-analysis[J]. Laryngoscope, 2021, 131(8): 1761-1768. doi:10.1002/lary.29414
[31] Malard O, Thariat J, Cartier C, et al. Guidelines of the French society of otorhinolaryngology-head and neck surgery(SFORL), part II: management of recurrent pleomorphic adenoma of the parotid gland[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2021, 138(1): 45-49. doi:10.1016/j.anorl.2020.08.009
[32] 李超, 徐义全, 樊晋川. 腮腺多形性腺瘤安全手术切缘研究进展[J]. 中国肿瘤临床, 2011, 38(4): 238-240. doi: 10.3969/j.issn.1000-8179.2011.04.017 LI Chao, XU Yiquan, FAN Jinchuan. Advances in the research of surgical margins for pleomorphic adenoma of parotid gland[J]. Chinese Journal of Clinical Oncology, 2011, 38(4): 238-240. doi: 10.3969/j.issn.1000-8179.2011.04.017
[33] 温玉明, 陈润良, 王昌美. 腮腺多形性腺瘤腺体切除范围的病理依据[J]. 华西口腔医学杂志, 2003,(5): 359-360. doi: 10.3321/j.issn:1000-1182.2003.05.008 WEN Yuming, CHEN Runliang, WANG Changmei. The Pathologic Basis of Partial Parotidectomy in Parotid Pleomorphic Adenoma Treatment[J]. West China Journal of Stomatology, 2003,(5): 359-360. doi: 10.3321/j.issn:1000-1182.2003.05.008
[34] Zbären P, Stauffer E. Pleomorphic adenoma of the parotid gland: histopathologic analysis of the capsular characteristics of 218 tumors[J]. Head Neck, 2007, 29(8): 751-757. doi:10.1002/hed.20569
[35] 梁军, 荆少红, 吴振婵, 等. 腮腺多形性腺瘤包膜特征与手术边界的确定[J].中国口腔颌面外科杂志, 2013, 11(6): 477-481 LIANG Jun, JING Shaohong, WU Zhenchan, et al. Capsule characteristics of parotid pleomorphic adenoma and determination of safe surgical margins[J]. Chinese Journal of Oral and Maxillofacial Surgery, 2013, 11(6): 477-481
[1] 曾婉婷,陈彦任,谭韵,李特,张民,关力谦,陈继川,姬长友,刘蓉蓉. 腮腺恶性肿瘤临床病理分析81例[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 104-106.
[2] 李晨,黄建民,王德生. 显微镜下功能性腮腺切除术治疗腮腺良性肿瘤42例[J]. 山东大学耳鼻喉眼学报, 2011, 25(4): 13-.
[3] 曾冬前,项俊,陈禹武,顾东胜,王天生. 甲状腺手术美观性技巧改进[J]. 山东大学耳鼻喉眼学报, 2009, 23(3): 23-24.
[4] 张家雄,肖 琴,魏 明,周文茹,唐雅男,庞 玲,邹文焘,朱玉芳 . 两种腮腺肿瘤切除术比较[J]. 山东大学耳鼻喉眼学报, 2007, 21(4): 355-356 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 杨长亮,黄治物,姚行齐,诸勇,孙艺 . 正常气骨导听性脑干反应及其应用[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 9 -13 .
[2] 王红霞,王鹏程 . NSE、S100及GFAP在视网膜母细胞瘤中的表达及意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 263 -264 .
[3] 于志良,王卫卫,王明华 . 耳鼻喉综合动力系统切除会厌囊肿23例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 278 -279 .
[4] 张剑利,王跃建,陈伟雄,胡维维,李广民 . 免疫组化和连续切片在检测头颈鳞癌颈淋巴结微转移中的意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 299 -303 .
[5] 王洪江,李培华,刘 稳 . 鼻咽部炎性肌纤维母细胞瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 331 -332 .
[6] 刘凤安,陈宏杰,胡洪义,郑世信 . 人工耳蜗植入术后听觉言语效果的影响因素[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 333 -335 .
[7] 丁吉江,李永团,范洪江,薛卫国,郭朝斌 . 双侧鼻结石并鼻中隔穿孔1例[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 349 -349 .
[8] 陈凤华,马建民,王宁利,王津津 . 人Tenon′s囊成纤维细胞的离体培养及生长特性观察[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 350 -352 .
[9] 和守盰,陈 斌,殷善开,苏开明,姜 晓 . OSAHS患者UPPP手术前后上气道形态学变化[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 385 -388 .
[10] 朱春生,陈剑秋 . 靶向性重组TRAIL基因诱导人黑色素瘤细胞株A375凋亡的效应[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 408 -411 .