改良向心性途径腮腺切除术治疗178例腮腺良性肿瘤

Benign Tumors of Parotid Glands Treated with a Modified Centripetal Approach to Parotidectomy

使用改良向心性途径腮腺切除术治疗178例腮腺良性肿瘤。先按腮腺导管表面标志,找到腮腺导管和而神经主颊支,在此平面沿而神经各分支纵轴作隧道式分离追踪到面神经主干。腮腺导管与而神经主烦支关系比较恒定,发现80%左右面神经主颊支横跨导管。面神经在直视下分离,不易误伤,且手术时间短,并发症少。

A modified centripetal approach to parotidectomy is reported. A total of 178 benign parotid tumors, 171 of which were primary and 7 of which were recurrent,were treated by this technique. The pleomorphic adenoma was the most common type (84.7%) in the series. Superficial parotidectomy was done in 169 cases, and total parotidectomy in 9 cases. This approach of operation based on the relation of the facial nerve is reletively constant. Initially the parotid duct and the main buccal branch of facial nerve werc identified. The duct was first divided (and picking up the proximal segment of duct). The procedure can be carefully performed backward along to main trunk of the facial nerve. The entire dissection must be done along the axis of nerve and the separation of gland from the facial nerve is accomplished whea the nerve is kept in view and without injury to the ficial nerve. Thus, the dissection can be done easier faster and safer. No a permanent facial palsy occured after parotidectomy in the cases group.