腮腺混合瘤个体化手术治疗对面神经功能影响的临床总结

Clinical Summary of Influence of Mixed Tumor of Parotid Gland Individual Surgery on the Function of Facial Nerve

目的探讨造成腮腺混合瘤手术切除后面神经损伤的原因。方法对76例腮腺混合瘤的患者采用个体化的手术方式,观察其对面神经功能的影响。结果76例患者中有26例手术后出现面瘫,占34%。其中腮腺区域性切除者面瘫发生率为22.2%,为暂时性面瘫;行腮腺浅叶和瘤体切除者面瘫的发生率为37.9%,均为暂时性面瘫;全叶切除者发生率为46%,1例为永久性面瘫。结论手术方式、手术范围、面神经的解剖方法是影响面神经功能损伤的主要原因,面瘫的发生率与手术术式、肿瘤与面神经的位置关系、以及面神经的解剖形态密切相关。

Objective To discuss the reason of facial nerve injury after surgical excision of parotid grand mixed tumor. Methods Individual surgery was performed in 76 patients with parotid gland mixed tumor and its influence on the function of facial nerve was observed. Results 26 patients（34%）had facial nerve paralysis and accounted. The incidence of facial nerve paralysis after parotid gland regional excision was 22.2%. The incidence was 37.9% after parotid gland shallow leaf and lump body excision and 46% after patotid gland whole leaf. 1 case was permanent facial nerve paralysis. Conclusion The surgery manner ,surgery scope,facial nerve ,facial nerve dissection method are the main reasons of influencing the function of facial nerve.The incidence of the facial paralysis is closely related with surgery manner, the location of tumor and facial nerve and the anatomy of facial nerve.