腮腺深叶肿瘤手术径路的选择  

Clinical Analysis on the Surgical Treatment of Deep Lobe Parotid Tumor （Report of 26 Cases）

作　　者：黄健 蔡博 龙星 唐中 

机构地区：[1]湖南省岳阳市二人民医院,湖南岳阳414000

出　　处：《医学临床研究》2009年第9期1662-1664,共3页Journal of Clinical Research

摘　　要：【目的】探讨腮腺深叶肿瘤手术径路的选择。【方法】回顾26例腮腺深叶肿瘤手术切除患者的临床资料，男性17例，女性11例，良性肿瘤11例，恶性肿瘤15例。口内径路切除肿瘤者11例；口外入路者15例，其中经颈侧切开者3例，经颈一腮腺联合下颌角劈开径路者2例，经颈-腮腺径路者5例；口内外联合切开者5例。【结果】所有患者术后随访观察1～10年，其中11例良性肿瘤患者均无复发；15例恶性肿瘤患者中4例死亡，3例复发。经颈-腮腺径路患者1例出现面神经损伤症状，口内径路者均未出现明显并发症。【结论】经口内径路仅用于较小的肿瘤切除，经颈-腮腺径路主要用于侵入咽旁间隙的腮腺深叶肿瘤的切除，经颈-腮腺联合下颌角劈开径路主要用于腮腺深叶肿瘤巨大者，口内外联合切开用于腮腺深叶肿瘤巨大者。[Objective] To explore the surgical approach to remove the tumor in the deep lobe parotid gland. [Methods] Fifty six cases including 17 males and 11 females were investigated. Among the cases, 11 cases were diagnosed benign neoplasm and 15 cases were diagnosed malignant tumor. For 11 cases, the tumors were removed through the intra-oral approach. Among the 15 cases whose tumors were dissected through the extra-oral approach, 3 cases were performed the operation through lateral cervical approach, 2 cases were per- formed the operation through parotid-cervical approach combined with temporal separation of the mandible an- gle, and 5 cases were performed the operation through parotid-cervical approach, and the other 5 cases were performed the operation through parotid-eervieal approach combined with intra-oral way. [ResultslAll the pa- tients were followed up 1 to 10 years. There were no apparent complications and recurrence of the tumors a- mong 11 cases diagnosed benign neoplasm. However, among the 15 patients diagnosed malignant neoplasm, 4 patients died postoperatively and 3 cases had recurrence. One patients had the complication of facial nerve dys- function postoperatively among the cases performed the operation through parotid-cervieal approach. The obvi- ous postoperative complications were not found among the cases whose tumors were removed through the in- tra oral approach. [Conelusion]Intra oral approach is only suitable for removing small tumor in deep lobe pa- rotid. Parotid cervical approach can be applied for removing the tumor in the deep lobe parotid invading into the parapharyngeal space. Parotid-cervieal approach combined with temporal separation of the mandible angle can be applied for removing the huge tumor in the deep lobe parotid. Combination of intra-oral and extra-oral approach also can be used for dissecting the huge tumor in the deep lobe parotid.

关 键 词：腮腺肿瘤/外科学 

分 类 号：R739.87[医药卫生—肿瘤]