改良面部除皱切口联合腮腺套在功能性腮腺外科中的应用  

The clinical applications of modified rhytidectomy incision combined elastic sleeve in functional parotidectomy

作　　者：陈莹华 陈良嗣[2] 罗小钢 胡跃馨 蒙国庆 张红春 CHEN Yinghua;CHEN Liangsi;LUO Xiaogang;HuYuexin;MENG Guoqing;ZHANG Hongchun(Department of Otolaryngology,Guangxi Nanning Red Cross Hospital,Nanning,Guangxi 530012,P.R.China)

机构地区：[1]广西南宁市红十字会医院耳鼻咽喉科,530012 [2]广东省人民医院耳鼻咽喉头颈外科,广州

出　　处：《中国中西医结合耳鼻咽喉科杂志》2023年第2期138-141,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：广西壮族自治区卫生健康委员会科研计划课题(Z20201521)。

摘　　要：目的评价改良面部除皱切口联合腮腺套在功能性腮腺外科中的应用价值。方法回顾我科对32例腮腺浅叶肿物采用改良面部除皱切口,实施功能性腮腺外科手术,其中4例肿瘤切除后术区缺损较大,行胸锁乳突肌瓣转移修复。全部术后使用腮腺套加压包扎。探讨该入路的术野暴露、美观程度,以及面瘫、面侧凹陷等并发症发生率,术后使用腮腺套预防涎瘘的效果。结果所有病例术野暴露良好,均能完整切除肿瘤及周围足够的腮腺组织。术后下颌缘支暂时性麻痹4例(12.5%),暂时性耳垂麻木8例(25%),均在2~3个月后缓解。Frey′s综合征3例(9.4%)。全部病例均无涎瘘发生。术后3个月所有患者对术后切口的平均客观美容满意度评分9分。4例术中行胸锁乳突肌瓣转移修复的患者术后1年复查,术区面侧与健侧相比无明显不对称性凹陷。随访24~50个月(中位随访期:36个月),未见肿瘤复发。结论改良面部除皱切口联合腮腺套应用于腮腺浅叶肿瘤手术,具有术野暴露良好、切口相对隐蔽、美容效果良好、切口I期愈合快、无明显并发症优点,符合功能腮腺外科理念,值得临床推广应用。Objective To evaluate the value of the modified rhytidectomy incision combined elastic sleeve in functional parotidectomy.Method Thirty-two cases of superficial parotid tumor were performed functional parotidectomy by modified rhytidectomy incision.Four cases who had large defects in the operative area after tumor resection,were repaired by sternocleidomastoid muscle flaps.Postoperative elastic sleeve was used in all cases.The follow-up study included the exposed region,the cosmetic effect of this approach and the incidence of related complications.Result All patients were satisfied and the tumor and sufficient parotid tissue were completely removed with this modified approach without salivary fistula.Temporary paralysis of the marginal mandibular branch of facial nerve were found in four cases,and seven cases felt insensible earlobe after operation,and they all recovered in 2 to 3 months.Four patients who were repaired with sternocleidomastoid muscle flaps during operation were reexamined after 1 years.There was no significant asymmetric depression on the operative side compared with the healthy side.No recurrence happened during the 24-50 months’follow-up period(median follow-up period:36 months).Conclusion The modified rhytidectomy incision combined postoperative elastic sleeve provided good exposure,had less complications and better cosmetic outcome,which is worthy of clinical application in functional parotidectomy.

关 键 词：腮腺手术 腮腺肿瘤 改良面部除皱切口 面神经 美容 

分 类 号：R739.8[医药卫生—肿瘤]