胸锁乳突肌瓣在腮腺良性肿瘤手术中的应用

Application of Sternocleidomastoid Muscle Flap in Operations for Parotid Benign Tumors

目的:探讨腮腺良性肿瘤切除术同期用胸锁乳突肌瓣修复面部凹陷畸形,及预防味觉出汗综合征的效果。方法:共141例腮腺良性肿瘤患者,行腮腺肿瘤及部分浅叶切除术。其中48例同期行胸锁乳突肌瓣转移修复,另93例未行组织瓣修复。术后6月～3年,观察面部畸形情况,并行碘-淀粉试验检查做客观评价。结果:常规手术组(对照组)均有不同程度的患侧面部凹陷畸形,93例患者中碘-淀粉试验阳性30例,占32.3%;胸锁乳突肌瓣转移组(实验组)面部凹陷均不明显,48例中碘-淀粉试验阳性3例,占14.6%,两组间存在显著差异(x2=7.40,P<0.01)。结论:腮腺良性肿瘤切除术同期行胸锁乳头肌瓣转移修复,可以有效治疗术后面部凹陷畸形及预防Frey's综合征的发生。

Objective： To access the effect of sternocleidomastoid muscle flap in the restoration of sunken deformity of face, and preventing Frey＇s syndrome after parotidectomy. Methods： In this study,141 patients of parotid benign tumor underwent part superficial lobectomy, and soft tissue defects of 48 patients were repaired by the sternocleidomastoid muscle flap as group A（experimental group）, the soft tissue defects of other93 patients were not repaired by any flap as group B （control group）. From 6 months to 3 years after operation,the sunken deformity of faces was observed, and all patients were examined by iodine starch test. Results： There were obvious sunken deformity of faces in group B, and 30 in 93 patients were positive in iodine starch test, with the rate of 32.3%. While there were no obvious sunken deformity of faces in group A, and only 7 in 48 patients were positive in iodine starch test,with the rate of 14.6%. The positive rate of iodine starch test were significantly lower in group A than that in group B （χ^2=7.40, P〈0.01）.Conclusions： Sternocleidomastoid muscle flap is effective to correct the deformity of face after parotidectomy and decrease the occurence of Frey＇s syndrome.