功能性腮腺外科  

Functional Parotid Surgery

作　　者：俞光岩[1] 马大权[1] 

机构地区：[1]北京大学口腔医学院口腔颌面外科,北京市100081

出　　处：《中国肿瘤临床》2010年第16期908-910,共3页Chinese Journal of Clinical Oncology

摘　　要：涎腺肿瘤是常见口腔颌面部肿瘤之一,腮腺是涎腺肿瘤最常见的部位。腮腺肿瘤的功能性外科是指在根治肿瘤的基础上,尽量保存腮腺及其相关组织的功能。部分腮腺切除术可以缩短手术时间、减轻面神经损伤、减轻面部凹陷畸形、降低味觉出汗综合征发生率及保留腮腺功能。保留腮腺咬肌筋膜可以降低味觉出汗综合征的发生率,保留腮腺导管可保留面神经深部腮腺的功能,保留耳大神经可避免或减轻耳垂麻木症状。对于低度恶性肿瘤与面神经紧贴者,保留面神经后采用术中冷冻加术后放疗,或采用^(125)I放射性粒子植入,可有效预防肿瘤复发。利用天然隐蔽区,采用耳后或耳前发际内切口,可提高术后的美容效果。功能性腮腺外科的实施,可明显减少手术并发症,提高患者的生存质量。Salivary gland tumor is one of the most common tumors in the oral and maxillofacial region and parotid gland is the most common location. Functional parotid surgery for parotid tumors involves conserving the gland and its related tissues as much as possible based on the ablation of the tumors. Partial parotidectomy is superior to superficial paroti- dectomy in the following aspects： shorter surgical duration, less damage to facial nerve, reduced facial deformity, lower incidence of Frey＇s syndrome, and preserved glandular function. The incidence of Frey＇s syndrome could be reduced if the superficial musculoaponeurotic system （SMAS） is preserved. The secretory function of the glandular tissue deep to the facial nerve could be preserved once Steven＇s duct is conserved. Earlobe numbness will be avoided or relieved once the great auricular nerve is preserved. For patients with low-grade malignant tumors, conservation of the facial nerve could be considered when the nerve adheres to the tumor. Intraoperative cryosurgery and postoperative radiotherapy are necessary. The alternative option for management of the facial nerve is ^125I seeds implant brachytherapy. Both options can well control tumor recurrence and facial nerve function can be recovered. Better aesthetic results without obvious scars can be achieved by using a face lift incision. Functional parotid surgery results in fewer complications and better quality of life for patients with parotid tumors.

关 键 词：腮腺肿瘤 腮腺切除术 功能性外科 面神经 腮腺咬肌筋膜 

分 类 号：R739.8[医药卫生—肿瘤]