改良面部除皱切口在腮腺浅叶肿瘤切除术中的应用  

The clinical application of modified rhytidectomy incision in superficial parotid tumor surgery

作　　者：徐志坚[1] 陈良嗣[2] 罗小宁[2] 张思毅[2] 宋新汉[2] 詹建东[2] 卢仲明[2] 

机构地区：[1]惠州市中心人民医院耳鼻咽喉一头颈外科,广东惠州516001 [2]广东省人民医院广东省医学科学院耳鼻咽喉-头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第10期738-740,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广东省科技计划项目(No:2011B080701035)

摘　　要：目的：评价改良面部除皱切口在腮腺浅叶肿瘤切除术中的应用价值。方法：采用改良面部除皱切口，实施面神经解剖加腮腺浅叶部分（或腮腺浅叶）切除术35例，观察该入路的术野暴露、美观程度及并发症发生率。结果：所有病例术野暴露良好，均完整切除肿瘤。术后面神经下颌缘支暂时性麻痹5例（14．3％），暂时性耳垂麻木6例（17．1％），均在1～3个月后缓解；无涎瘘；术后3个月患者平均客观美容满意度评分8．5分，所有患者对术后美容效果满意。随访24～60个月（中位随访期：48个月），未见肿瘤复发。结论：改良面部除皱切口应用于腮腺浅叶肿瘤切除，术野暴露良好、切口相对隐蔽、术后美容效果良好、无明显并发症，值得临床推广应用。Objective： To evaluate the modified rhytidectomy incision in superficial parotidectomy. Method： Thirty-five patients with superficial parotid tumor were included in this study. A modified rhytidectomy incision often used in facial plastic surgery was used for superficial parotidectomy and subtotal superficial parotidectomy with preservation of facial nerve and great auricular nerve. The follow-up study included the exposed region,the cosmetic effect of this approach and the rate of complication. Result： All patients healed without salivary fistula, and were satisfied with this modified approach. Temporary paralysis of the marginal mandibular branch of facial nerve were found in five patients, and six patients felt insensible around earlobe after operation. They all recovered in 1 to 3 months after surgery. , no recurrence was happened during follow-up in 36 to 60 months（ median follow-up period was 48 months ）. Conclusion：The modified rhytidectomy incision provided good exposure ,had less complication and better cosmetic outcome.

关 键 词：腮腺手术 改良面部除皱切口 改良Blair切口 面神经 美容 

分 类 号：R766[医药卫生—耳鼻咽喉科]