胸锁乳突肌瓣修复改善腮腺术后外观畸形  

Sternocleidomastoid muscle flaps reconstruction to improve the facial deformity of parotidectomy

作　　者：曾宪平[1] 李娟[1] 汤苏成[1] 黎景佳[1] 张剑利[1] 何发尧[1] 陈伟雄[1] 陈合新[2] Zeng Xianping;Li Juan;Tang Sucheng;Li Jingjia;Zhang Jianli;He Fayao;Chen Weixiong;Chen Hexin(Department of Otorhinolaryngology,The First Peoples Hospital of Foshan,Foshan 528000,China;Otolaryngology Institute,Otorhinolaryngology Hospital,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]佛山市第一人民医院耳鼻咽喉头颈外科,广东佛山528000 [2]中山大学附属第一医院耳鼻咽喉科医院,广州510080

出　　处：《中国临床解剖学杂志》2022年第1期81-84,88,共5页Chinese Journal of Clinical Anatomy

基　　金：广州市科技计划基金(No.201806020125;No.201707010105)。

摘　　要：目的研究胸锁乳突肌瓣(SCM)填充对腮腺手术并发症及术后外观的影响。方法68例腮腺良性肿瘤患者,随机数字表法分为实验组和对照组。对照组34例接受常规腮腺肿物区域切除术,实验组34例在接受腮腺肿物区域切除术后,以SCM填充术区缺损。随访6~12个月,对术后并发症和术区外观进行主观和客观的评价。结果实验组在术后面神经麻痹、主观Freys综合征、耳部麻木感、肿瘤复发的发生率和对照组大致相当。实验组术后5例(15%)发生腮腺瘘,对照组9例(27%)发生腮腺瘘,实验组腮腺瘘发生率低于对照组,差异有统计学意义(P﹤0.05)。实验组外观患者主观评分为(1.25±0.96);第三者的评分(1.11±0.99),对照组外观患者主观评分为(2.45±1.33);第三者的评分(2.26±0.87),两组患者外观的主观和客观评分差异均有统计学意义(P﹤0.05)。结论SCM填塞腮腺术腔可改善患者术后面部畸形,为腮腺术后的重建提供了合理的美容选择。Objective To investigate the effect on facial deformity and complications of sternocleidomastoid flaps(SCM) in the resection of benign parotid tumors. Methods Sixty-eight patients with benign parotid tumors were randomly divided into a control group and an experimental group. Thirtyfour patients in the control group were treated with traditional parotidectomy, while other 34 patients in the experimental group with sternocleidomastoid flap transferred to fill sunken operative area for repair after routine resection of parotid lesions. All the patients were followed for at least 6~12 months. The incidence of postoperative complications and facial deformity were compared and evaluated between the two groups.Results The complained of postoperative facial palsy, Frey syndrome, numbness in the ear, tumor recurrence rate were roughly same between the two groups. The incidence of salivary fistula in the experimental group(accounting for 15%) was significantly lower than that in the control group(accounting for 27%), with the statistical difference(P<0.05). The cosmetic result on the experimental group, the patient completed scores was(1.25 ± 0.96), and the scores from the blinded health care staff was(1.11 ± 0.99), while those in the control group were(2.45±1.33) and(2.26±0.87), respectively. There were statistical differences in the subjective and objective scores of patients cosmetic result between the two groups(P<0.05).Conclusions SCM parotid gland filling can improve postoperative facial deformities and provide a reasonable aesthetic choice for parotid gland reconstruction.

关 键 词：腮腺良性肿瘤 胸锁乳突肌瓣 味觉出汗综合征 涎瘘 

分 类 号：R762[医药卫生—耳鼻咽喉科]