隐蔽切口入路内镜辅助颈部肿物切除效果初探  

A novel surgical technique for neck neoplasms:endoscope-assisted resection of benign tumors via a small concealed incision

作　　者：石亮[1] 宋晓彬[1] 王克涛[1] 刘超[1] 谈万业[1] 王勇[1] Shi Liang;Song Xiaobin;Wang Ketao;Liu Chao;Tan Wanye;Wang Yong(Department of Oral and Maxillofacial Surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院口腔颌面外科,济南250012

出　　处：《中华口腔医学杂志》2020年第2期115-118,共4页Chinese Journal of Stomatology

摘　　要：目的探索评价颌面部隐蔽切口入路内镜辅助下颈部良性肿瘤切除的新术式。方法选取2018年1月至2019年8月于山东大学齐鲁医院口腔颌面外科就诊的颈部良性肿瘤患者17例(颏下区3例,下颌下区2例,腮腺后下极9例,胸锁乳突肌上区1例,胸锁乳突肌中区1例,胸锁乳突肌下区1例)。术前行CT检查,评价肿瘤大小、边界、形态、性质,根据肿瘤所在区域设计不同部位隐蔽切口,颏下区及下颌下区肿物选用口内前庭沟入路,腮腺后下极及胸锁乳突肌区肿物选用耳后隐蔽小切口入路。术中采用自制的"口腔手术用造腔装置"辅助牵拉完成颈部"造腔",内镜辅助下将肿物完整摘除,术后每3个月定期随访。结果所有手术均按预期完成,术后3个月复查时,视觉模拟量表平均为9.3分,患者对切口设计及手术整体效果均表示满意,术后1~15个月随访均未见复发。结论采用隐蔽切口入路内镜辅助颈部良性肿物切除是一种切口不明显、具有良好美容效果的手术方法。Objective To introduce a new surgical procedure for the treatment of neck benign tumors by endoscopic techniques.Methods Seventeen patients with neck benign tumor underwent surgery by endoscope through a concealed incision in Department of Oral and Maxillofacial Surgery,Qilu Hospital of Shandong University from January 2018 to August 2019 were analyzed,which included 3 cases of tumor in the submental area,2 cases in submandibular region,9 cases in lower pole region of parotid gland,1 case in superior region of sternocleidomastoid muscle,1 case in central region of sternocleidomastoid muscle,1 case in inferior region of sternocleidomastoid muscle.All patients underwent routine preoperative examination and CT examination to evaluate tumor size,boundary,morphology and nature.According to the area where the tumor located,concealed incisions in different sites were designed.Lumps in the submental area and submandibular area were treated with oral vestibular sulcus incision.Benign tumors located in the lower pole region of parotid gland and the sternocleidomastoid muscle region were treated with approach of the short hidden postauricular incision.During the operation,the self-developed"maxillofacial suspension device"was used to provide the operating space.The tumors were completely removed with endoscope and all patients were followed up every 3 months.Results All surgical procedures were performed as expected.Visual analogue scale(VAS)was 9.3 on average at 3 months after operation,all the patients were satisfied with the incision design and the cosmetic effect.No recurrences were found in patients with a follow-up period ranged from 1-15 months.Conclusions These studies have shown that endoscope-assisted neck benign tumor resection is a surgical procedure with covert incision and good cosmetic results.

关 键 词：头颈部肿瘤 内窥镜 口腔前庭沟切口 耳后切口 

分 类 号：R73[医药卫生—肿瘤]