两种手术径路对颌下腺良性疾病面神经下颌缘支保护的效果分析  

Effect analysis of two surgical approaches for the protection of the mandibular marginal branches of facial nerve in submandibular gland benign diseases

作　　者：宁玉东 王薇 曾定芬 蔡永聪 姜健 孙荣昊 周玉秋 郑王虎 汪旭 何天琪 李超 NING Yudong;WANG Wei;ZENG Dingfen;CAI Yongcong;JIANG Jian;SUN Ronghao;ZHOU Yuqiu;ZHENG Wanghu;WANG Xu;HE Tianqi;LI Chao(Department of Head and Neck Surgery,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Cancer Hospital Affiliate to School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院头颈外科四川省肿瘤研究所四川省癌症防治中心电子科技大学医学院附属肿瘤医院头颈外科,四川成都610041

出　　处：《中国耳鼻咽喉颅底外科杂志》2021年第1期90-93,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：四川省卫健委适宜技术推广项目-甲状腺结节规范化诊治技术项目推广(18SYJS07)。

摘　　要：目的对比分析两种不同手术途径对颌下腺良性疾病面神经下颌缘支的保护效果。方法选择2014年12月—2018年6月在四川省肿瘤医院初次手术的134例颌下腺良性疾病患者,分别采用不同手术入路进行颌下腺全切术,术式1:颈阔肌下翻瓣显露面神经下颌缘支;术式2:不显露面神经下颌缘支,仅在颌下腺表面分离;术后均随访6个月以上,统计两种不同途径手术的面神经下颌缘支损伤并发症出现的情况,运用t检验进行统计学对比分析。结果运用术式1的患者中有2例出现暂时性口角歪斜,随访6个月后恢复正常,运用术式2的患者均无口角歪斜症状,两组并发症发生情况无统计学差异(P>0.05)。结论两种手术途径均可有效保护面神经缘支,初学者建议加强颌下腺及面神经局部解剖知识。Objective To compare the effects of two surgical approaches on the protection of the mandibular marginal branch of the facial nerve in benign submandibular gland diseases.Methods A total of 134 patients with benign submandibular gland diseases who underwent primary surgery in Sichuan cancer hospital from December 2014 to June 2018 were chosen.Total submandibular gland resection was performed through two approaches.The mandibular marginal branch of facial nerve was exposed by approach 1,but not exposed and only separated on the surface of submandibular gland by approach 2.The incidence of complications of mandibular marginal branch injuries in two different surgical approaches was statistically analyzed(the follow-up time was more than 6 months),and T test was used for statistical comparison.Results Among the patients using approach 1,2 cases developed temporary askew mouth and returned to normal after 6 months of follow-up.Patients using approach 2 showed no symptoms of askew mouth.There was no statistical difference in the incidence of complications between the two groups(P>0.05).Conclusions Both surgical approaches can effectively protect the marginal branch of facial nerve.It is suggested that beginners should strengthen the local anatomy of submandibular gland and facial nerve.

关 键 词：头颈外科 颌下腺 面神经下颌缘支 手术途径 

分 类 号：R739.91[医药卫生—肿瘤]