内镜辅助下单一隐蔽切口入路面颊中部良性肿瘤切除效果初探  

Preliminary report of the effect of endoscopically assisted resection of mid-cheek benign tumors via a single hidden incision

作　　者：季翀昊 王勇[1] 王克涛[1] 赵明宇 石亮[1] Ji Chonghao;Wang Yong;Wang Ketao;Zhao Mingyu;Shi Liang(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》2023年第11期1165-1171,共7页Chinese Journal of Stomatology

摘　　要：目的总结内镜辅助下通过耳屏内或口内两种隐蔽切口入路行面颊中部良性肿瘤切除术的初步经验,探讨面颊中部良性肿瘤切除中内镜辅助技术的应用适应证及优缺点。方法前瞻性纳入2018年4月至2022年11月就诊于山东大学齐鲁医院口腔颌面外科的36例面颊中部良性肿瘤患者,其中男性11例,女性25例,年龄(37.2±15.9)岁(11~65岁)。采用随机数字表法将患者分为两组,分别采用耳屏内切口入路(耳屏内组19例)和口内切口入路(口内组17例)。统计比较两组患者的肿瘤最大径、切口长度、手术时间、术中出血量、术后引流量及时间、美学满意度、围手术期并发症和随访情况。结果两组患者的手术过程均按预期完成。耳屏内组患者肿瘤最大径[(2.2±0.9)cm]与口内组[(2.1±0.7)cm]差异无统计学意义(t=0.46,P=0.687)。两组患者的手术切口长度和手术时间差异均无统计学意义(t=1.57,P=0.100;t=0.44,P=0.736)。口内组术中出血量[(23.6±8.9)ml]显著少于耳屏内组[(30.8±8.7)ml](t=2.97,P=0.006),美观满意度显著高于耳屏内组(t=3.44,P=0.015)。耳屏内组出现2例耳垂麻木,1例暂时性面瘫;口内组有2例术后积液,未观察到神经损伤迹象。术后随访1~54个月,两组均未见肿瘤复发。结论采用单一耳屏内或口内隐蔽切口入路于内镜辅助下切除面颊中部良性肿瘤均可获得较好的美观及微创效果,围手术期并发症少,手术效果满意。Objective To summarize the preliminary experience of endoscopically assisted mid-cheek benign tumor resection using a single preauricular or transoral incision and to evaluate its indications,advantages,and disadvantages.Methods Thirty-six patients with benign mid-cheek tumors were prospectively enrolled,including 11 males and 25 females,aged(37.2±15.9)years and ranged from 11 to 65 years old.The patients were randomly divided into two groups:endoscope-assisted tumor dissections through a single preauricular incision(preauricular group,19 cases)or transoral incision(transoral group,17 cases).Their surgical approaches were introduced,and the tumor long-axis length,incision length,operative time,estimated intraoperative bleeding,postoperative drainage amount and time,aesthetic satisfaction,perioperative complications,and follow-up were recorded and analyzed.Results The difference between the tumor long-axis lengths in the preauricular group[(2.2±0.9)cm]and the transoral group[(2.1±0.7)cm]was not statistically significant(t=0.46,P=0.687),and all surgical procedures were completed as planned.There was no significant difference in the incision size(t=1.57,P=0.100)or operative time(t=0.44,P=0.736).Compared with the preauricular group[(30.8±8.7)ml],transoral group[(23.6±8.9)ml]significantly reduced intraoperative blood loss(t=2.97,P=0.006)and improved aesthetic pleasure(t=3.44,P=0.015).Two cases of earlobe numbness and one case of temporary facial palsy were observed in the preauricular group;two cases of postoperative effusion were noted in the transoral group,and no signs of nerve injury were detected.No tumor recurrence was found during the 1-54-month of follow-up.Conclusions Endoscopic-assisted preauricular or transoral incision for dissecting mid-cheek benign tumors provides excellent aesthetic and minimally invasive results,reducing complications and obtaining satisfactory aesthetic results.

关 键 词：面部肿瘤 面颊中部 内镜 耳屏内切口 口内切口 

分 类 号：R739.8[医药卫生—肿瘤]