腮腺肿瘤的个性化治疗  

Personalized surgery in patients with parotid tumors

作　　者：王佩林[1] 李保卫[1] 韩浩伦[1] 王鸿南[1] 王刚[1] 

机构地区：[1]解放军306医院耳鼻咽喉头颈外科,北京100101

出　　处：《总装备部医学学报》2012年第4期203-205,共3页Medical Journal of General Equipment Headquarters

摘　　要：目的探讨不同类型腮腺肿瘤的个性化治疗方式及其规律。方法选择2002年1月～2011年12月间在我院住院手术治疗的腮腺肿瘤115例,按其肿瘤部位的不同(腮腺上部和下部)采取相应的手术方式,恶性肿瘤术后配合放射治疗,术后随访0.5～9年,评测其治疗效果和术后并发症。结果腮腺良性肿瘤95例,术后暂时性面神经麻痹17例,1～3个月后恢复;Frey’s综合征3例;未出现复发、涎瘘和明显面部凹陷。恶性肿瘤20例,采取腮腺全切术或加舌骨上颈淋巴结清扫术,术后出现暂时性面神经麻痹15例,永久性面神经麻痹5例(其中2例术前已存在面瘫)。术后放射治疗18例,随访0.5～8.5年未复发;术后未行放射治疗2例,2年后复发;因心血管疾病死亡1例。结论腮腺良性肿瘤行个性化治疗是理想的选择;恶性肿瘤在腮腺全切的基础上选择性行舌骨上颈淋巴结清扫术,术后需放射治疗。Objective To explore a variety of personalized treatment options for parotid gland tumors and to explore the functional and precise surgery. Methods A retrospective study of 115 cases of parotid gland tumors was analyzed. The tumors in the upper and lower part of the parotid gland were performed with appropriate surgical approach, respectively, and malignant tumor treated with radiation therapy after surgery. Patients had been followed up for 0.5～9 years, Evaluation of treatment and postoperative complications was conducted. Results 17 postoperative temporary facial paralyses after 95 cases of benign tumor surgeries, were recovered after 1 to 3 months, including 3 Frey's syndromes, with no recurrence, salivary fistula, and obvious facial depression. 20 cases of malignant tumors were treated by parotid total excision or suprahyoid neck dissection, with 15 postoperative temporary facial paralyses and 5 permanent facial paralyses, including two cases of preoperative paralyses; 18 cases of them received postoperative radiation after surgery without recurrence, but 2 cases without radiotherapy, and recurrence after two years. Conclusion Personalized treatment of the benign tumor is an ideal choice. Parotidotomy, suprahyoid neck dissection and postoperative radiotherapy are optional approaches for malignant tumors of the parotid.

关 键 词：腮腺肿瘤 治疗 并发症 

分 类 号：R739.87[医药卫生—肿瘤]