应用耳后发迹切口区域切除腮腺后下极良性肿物  

Extracapsular dissection of benign tumors at the posterioinferior portion of parotid gland using a retroauricular hairline incision approach

作　　者：赵清桐[1] 沈山[1] 张春雷[1] 

机构地区：[1]暨南大学附属第一医院口腔医疗中心,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2010年第4期407-410,共4页Journal of Jinan University(Natural Science & Medicine Edition)

摘　　要：目的：探讨腮腺后下极良性肿瘤改良切口及术式的临床效果及其合理性。方法：78例患者随机分为两组,第1组耳后发迹切口行保留腮腺咬肌筋膜、保留耳大神经和腮腺区域切除术的腮腺良性肿瘤改良术式,第2组传统的＂S＂形切口行传统腮腺浅叶切除术;术后随访2~4年。记录手术出血量、手术时间,临床检查暂时性面瘫和术后肿瘤复发情况,行Minor试验,问卷调查味觉出汗综合征发生率、耳垂区感觉及面部畸形情况。采用SPSS 13.0软件包对数据进行t检验或2检验。结果：两组对比显示腮腺良性肿瘤改良术式的出血量、手术时间和术后暂时性面瘫显著低于传统腮腺浅叶切除术,涎瘘和术后肿瘤复发率两组无显著性差异。两组味觉出汗综合征的发生率,微量淀粉碘试验结果和患者疤痕满意度均有统计学差异（P〈0.05）;保留耳大神经,耳垂区麻木症状发生率明显降低。结论：应用耳后发迹切口腮腺良性肿瘤改良术式可以减少手术出血量,缩短手术时间,显著地减少味觉出汗综合征、耳垂区感觉障碍的发生率,患者术后面部畸形也获得良好改善。Aim：A clinical perspective study was designed for patients undergoing a modified incision and parotidectomy to reduce complications of parotidectomy. Methods： Seventy-eight patients were divided randomly into two groups;group 1（45 cases） was treated with preserving the fascia parotideomasseterica and great auricular nerve and partial parotidectomy using a retroauricular hairline incision approach.group 2（33 cases） was operated on via superficial parotidectomy using routine S-shaped incision.All patients were followed up for 3~9 years,blood loss,operating time,temporary facial paralysis,tumour recurrence were compared between the two groups.The incidence of Frey＇s syndrome was clinically evaluated by Minor test（starch-iodine test）.The feeling of the region around the auricular lobule and facialdeformity was also evaluated.The data were analyzed using SPSS13.0 software package for Student＇s t test and Chi-square test.Results： The bleeding volume,operating time and temporary facial paralysis in group 1 was significantly lower than that in group 2.There was no significant difference between the two groups in sialosyrinx and tumor recurrence.The incidence of Frey＇s syndrome in group 1 was significantly lower than that in group 2 by objective observation、 Minor test and Patient satisfaction for scar（P0.05）.There was significant difference between the feeling before and after operation in the auricular lobule.Conclusion：The modified parotidectomy using a retroauricular hairline incision approach is a function-preserving surgery for benign parotid tumours,which improves the cosmetics,the feeling around ear,reduces the operating time,and the incidence of Frey＇s syndrome.

关 键 词：腮腺后下极良性肿瘤 腮腺区域切除术 耳后发迹切口 并发症 

分 类 号：R782.2[医药卫生—口腔医学] R739.8[医药卫生—临床医学]