老年人腮腺恶性肿瘤手术切除及即刻修复的疗效分析  

The curative effect of parotid gland malignant tumor resection and simultaneous reconstruction on the aged

作　　者：韩万放[1] 周锐华[2] 郭广霞[1] 谷爱玲[1] 步荣发[3] 

机构地区：[1]河南省濮阳市人民医院口腔颌面外科,主任副主任医师河南457000 [2]河南省濮阳市油田总医院烧伤整形科,副主任医师河南457001 [3]解放军总医院口腔颌面外科,主任医师教授北京100853

出　　处：《中华老年口腔医学杂志》2009年第5期276-278,共3页Chinese Journal of Geriatric Dentistry

摘　　要：目的:探讨老年人腮腺恶性肿瘤手术切除后即刻修复重建手术方法的可行性,并评价临床疗效。方法:对23例腮腺恶性肿瘤依据临床分期、病理类型,选择腮腺全部切除并面神经部分切除6例,全部切除5例,广泛切除3例,联合根治性颈淋巴清扫术9例。术后即刻行皮瓣、肌皮瓣、复合组织瓣移植或游离移植15例,同时行耳大神经移植修复面神经4例,面部表情肌的动、静态功能重建16例。结果:术后患者面部对称或基本对称,功能满意。5年病死率17.4%(4/23),10年病死率52.2%(12/23)。结论:切除肿瘤及即刻修复重建手术符合整形美容外科的发展要求,具有重要的临床意义。Objective： To analyze the effects of extensive excision and immediate reconstruction of parotid gland malignancies on the aged, and explore the immediate reconstruction＇s feasibility, and appraises the clinical curative effect. Method： 23 cases with different diagnostic malignant neoplasms, stages, histopathological types, were undertaken total parotidectomy with sacrifise of facial nerve partially （6 cases） or totally （5 cases）. Among them, 3 cases underwent extensive excision, 9 ipsilateral neck dissection, 15 cases with immediately skin flap, myocutaneous flap, compound tissue flap by vascular anastomosis transplant, with application of great auricular nerve transplant repair facial nerve in 4 cases, the static function restored and improved dynamic result for the facial muscles in 16 cases. Results： Patient faces showed postoperatively symmetry or almost symmetry, the function is satisfied. 5 year mortal rate 17.4% （4/23）, 10 year mortal rate 52.2% （12/23）. Conclusions： Simultaneous reconstruction surgery is also suitable for the aged, which not onl;y prevents and controls the tumor recurrence, but improves the living sdandard also. The immediate plastic and aesthetic surgery has also the important clinical significance for the aging patients.

关 键 词：腮腺 恶性肿瘤 手术 面神经 修复 

分 类 号：R739.8[医药卫生—肿瘤]