耳屏前切口在腮腺上极良性肿物切除中的应用  

The use of the incision before tragus in regional parotidectomy

作　　者：俞辉明[1] 房进[1] 吴煜农[2] 施卫兵[3] 

机构地区：[1]南京医科大学附属淮安第一医院口腔科,江苏淮安223300 [2]南京医科大学附属口腔医院口腔颌面外科,江苏南京210029 [3]高邮市人民医院口腔科,江苏高邮225600

出　　处：《南京医科大学学报（自然科学版）》2012年第9期1307-1310,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省高校优势学科建设工程资助项目(2011-137)

摘　　要：目的:对腮腺上极良性肿物采用耳屏前切口,行肿物及周围腺体的区域切除术,与常规"S"切口行同样术式比较,观察治疗效果。方法:腮腺上极肿物患者40例,随机分为两组:实验组采用耳屏前切口,对照组采用耳前-颌后-颌下"S"形切口,均行肿物及区域性腺体切除术,解剖并保留相关的面神经、耳大神经分支。术后比较两组患者的手术时间、组织反应程度、耳大神经功能、面神经功能、Frey’s综合征、肿瘤复发率、涎瘘发生率、面部外形、患者满意度,综合评价治疗效果。结果:耳屏前切口组手术时间短、术后渗出少,局部肿胀轻,瘢痕隐蔽,Frey’s综合征发生率低,耳大神经功能障碍轻,患者满意率高,上述指标均有统计学差异(P<0.05)。两组患者肿瘤复发率、面神经功能障碍、涎瘘发生率无明显差别(P>0.05)。结论:耳屏前切口入路切口短、创伤小、瘢痕隐蔽、对容貌影响小、节省手术时间、并发症低于传统术式。Objective：To observe the result of two incisions in patients with benign tumor on the upper part of parotid gland after regional parotidectomy.Methods：Forty cases were divided into two groups randomly.All patients were performed parotidectomy with the incision before tragus in group 1 and routine ＂S＂-shape incision in group 2 respectively.Follow-up was carried out from 1 week to 2 years post operation to observe the treatment result.Results：There were less time of operation,less tissue reaction,less scar,less incidence of Frey＇s syndrome and the great auricular nerve dysfunction but more beautiful outlook and more satisfaction in group 1 than those in group 2（P 〈0.05）.There was no difference on relapse rate and incidence of partial facial nerve injury and salivary fistula among two groups（P 〈0.05）.Conclusion：The trauma and some postoperation complications were reduced in the new technique.This surgical approach presented could achieve a better facial cosmetic result in the parotid gland surgery.

关 键 词：良性肿物 腮腺 手术切口 创伤 并发症 

分 类 号：R739.8[医药卫生—肿瘤]