腮腺良性肿瘤功能性外科治疗的临床分析  

Clinical analysis of functional surgery for the treatment of benign tumor in parotid gland

作　　者：李超[1,2] 陈建超[1,2] 王朝晖[1,2] 张兵[1,2] 李彬[1,2] 王薇[1,2] 吴砚[3] 

机构地区：[1]四川省肿瘤医院 [2]四川省肿瘤研究所头颈外科,成都610041 [3]上海同济大学附属第十人民医院口腔科

出　　处：《实用口腔医学杂志》2011年第4期539-543,共5页Journal of Practical Stomatology

基　　金：四川省卫生厅科研资助课题(编号:090538);四川省肿瘤医院院课题(编号:2010012)

摘　　要：目的:比较不同手术方式治疗腮腺良性肿瘤的疗效,临床参数和术后并发症。方法:88例腮腺良性肿瘤患者被随机分为2组,传统术式组47例,即保留面神经,肿瘤及腮腺切除术;功能性外科治疗术式组41例,即美容除皱切口、胸锁乳突肌肌瓣、植入脱细胞真皮基质和保留面神经及耳大神经的肿瘤及腮腺部分切除术。通过3～30个月的随访,观察术后肿瘤复发、面瘫、涎瘘、Frey综合征、耳廓区麻木感、面部外形、口干、手术时间、出血量及术后住院时间情况。结果:2组相比,面瘫、肿瘤复发、口干和涎瘘发生率以及手术时间、出血量、术后住院时间差异均无显著性。传统的术式组耳廓区麻木感、Frey综合征和面部外形明显不对称的发生率分别为65.96%、31.91%和42.55%;功能性腮腺切除术组的发生率分别为36.59%7、.32%和9.76%(P<0.05)。结论:与传统腮腺术式相比,功能性腮腺切除术不增加手术时间和出血量,术后并发症较少。Objective： To compare the curative effects,clinical parameters and complications between conventional operation and functional surgery for the treatment of benign tumor in parotid gland.Methods： 47 patients with benign tumor in parotid gland received traditional surgery,i.e.excision of tumor with parotidectomy,but facial nerves were reserved;41 received functional surgery procedures,i.e.facelift incision,sternocleidomastoid flap,implantation of acellular dermal matrix,tumor removal with partial parotidectomy and with preservation of facial nerve and great auricular nerve.Patients were followed up for 3 to 30 months.Results： There were no significant difference between functional and conventional parotidectomy in the facial paralysis,tumor recurrence rate,dry mouth,salivary fistula,time for operation,volume of blood bleeding and time of hospitalization after operation（P0.05）.In the conventional operation group,the incidences of anaesthesia of auricular region,Frey＇s syndrome and facial asymmetry were 65.96%,31.91% and 42.55%,those in functional parotidectomy group were 36.59%,7.32% and 9.76% respectively（P0.05）.Conclusion： Functional parotidectomy is feasible in the treatment of parotid gland benign tumor because of less postoperative complications.

关 键 词：腮腺良性肿瘤 腮腺切除术 味觉出汗综合征 并发症 功能性外科治疗 

分 类 号：R739.8[医药卫生—肿瘤]