两种面神经解剖方式在腮腺浅叶良性肿瘤切除术中的比较研究  

A comparative study of two facial nerve anatomy methods in the resection of benign tumors in the superficial lobe parotidgland

作　　者：代伟林 向元俤[1] 李烁 陈沛[1] DAI Weilin;XIANG Yuandi;LI Shuo;CHEN Pei(Department of Otolaryngology,Wuhan No.1 Hospital,WuHan,Hubei,430022,China;Department of Otolaryngology,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen,Guangdong,518025,China)

机构地区：[1]武汉市第一医院耳鼻咽喉科,湖北武汉430022 [2]华中科技大学协和深圳医院耳鼻咽喉科,广东深圳518025

出　　处：《中国耳鼻咽喉头颈外科》2023年第4期237-240,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：武汉市卫健委医学科研课题面上项目(WX19C07);武汉市科技局应用基础前沿项目(2020020601012310)。

摘　　要：目的比较两种面神经解剖方法在腮腺浅叶良性肿瘤切除术中的临床疗效。方法选择手术治疗的腮腺浅叶良性肿瘤患者62例,随机分成两组。观察组(32例)选择沿下颌缘支的逆行法解剖面神经并切除肿瘤,对照组(30例)选择顺行法解剖面神经并切除肿瘤。比较两组患者的手术时间、术中失血量、术后面神经麻痹、涎瘘、Frey综合征、耳周麻木及面部凹陷畸形的发生率。结果观察组手术时间、术中失血量、术后面神经麻痹、涎瘘、Frey综合征、耳周麻木及面部凹陷畸形的发生率分别为(33.57±21.44)min、(31.14±28.36)ml、6.25%、12.50%、15.63%、6.25%和6.25%,对照组分别为(47.31±18.52)min、(44.22±23.82)ml、6.67%、10.00%、20.00%、16.67%和6.67%。与对照组比较,观察组手术时间短,术中失血量少,术后耳周麻木的发生率低,差异有统计学意义(P<0.05),而术后面神经麻痹、涎瘘、Frey综合征及面部凹陷畸形,差异无统计学意义(P>0.05)。结论在腮腺浅叶良性肿瘤切除术中,沿下颌缘支的逆行法相比顺行法可缩短手术时间,减少术中失血量,降低术后耳周麻木的发生率。OBJECTIVETo compare the clinical efficacy of two facial nerve anatomy methods on resection of benign tumor in the superficial lobe of parotid gland.METHODS A total of 62 patients with benign tumor in the superficial lobe of parotid gland were randomly divided into two groups.The observation group received tumor resection with retrograde anatomy of facial nerve along the mandibular marginal branch(32 cases),whereas the control group received tumor resection with anterograde anatomy of facial nerve(30 cases).The operation time,blood loss and incidence of postoperative facial paralysis,salivary fistula,Frey's syndrome,periauricular numbness,facial sunken deformity were compared between the two groups.RESULTS The operation time,blood loss,incidence of postoperative facial paralysis,salivary fistula,Frey's syndrome,periauricular numbness and facial sunken deformity in observation group were(33.57±21.44)min,(31.14±28.36)ml,6.25%,12.50%,15.63%,6.25%and 6.25%,respectively.Correspondingly,the control group were(47.31±18.52)min,(44.22±23.82)ml,6.67%,10.00%,20.00%,16.67%,and 6.67%,respectively.The operation time,blood loss and incidence of postoperative periauricular numbness in observation group were less than that of control group(P<0.05),there was no significant difference in the incidence of facial paralysis,salivary fistula,Frey's syndrome and facial sunken deformity after surgery between the two groups.CONCLUSION In the operation of benign tumor in superficial lobe of parotid gland,the retrograde approach along the marginal mandibular branch shortened the operation time,reduced the blood loss during operation and reduced the incidence of periauricular numbness after surgery compared with that of anterograde approach method.

关 键 词：腮腺肿瘤 手术后并发症 面神经 解剖 下颌缘支 

分 类 号：R739.87[医药卫生—肿瘤]