两种术式治疗腮腺良性肿瘤的初步评价

Comparison of Conventional Parotidectomy and Modified Parotidectomy for Benign Parotid Tumors

目的:比较传统腮腺切除术与改良腮腺切除术两种手术方式在腮腺良性肿瘤治疗中的优缺点,以期寻找更适合治疗腮腺良性肿瘤的方法。方法:将2001年5月～2004年6月100例腮腺良性肿瘤患者随机分为传统术式(A组)与改良术式(B组),对两者的手术方式和术后的面瘫、面部畸形、Frey's综合征(味觉出汗综合征)等进行比较。结果:术后2周及3个月时,A组面瘫发生率明显高于B组(P<0.05),但术后1年以后两组面瘫差异无显著性(P>0.05)。B组将耳前切口改为耳屏内切口,并将传统向颌下延长的"S"形切口改为向耳后延长,如此使得整个切口更为隐蔽,术后面部瘢痕不显著,对患者术后面容影响较小。术后3个月及12个月面部畸形的发生率和程度A组均高于B组(P<0.01)。Frey's综合征术后3个月时A组发生率为10%,B组发生率为2%,差异无显著性(P>0.05)。术后12个月A组明显高于B组(P<0.05)。结论:改良腮腺切除术治疗腮腺良性肿瘤在术后3年内的观察,可以减少并发症或后遗症的发生。

Objective： To compare conventional parotidectomy with modified parotidectomy for benign parotid tumors. Methods： From 2001 to 2004, data from 100 patients with benign parotid tumor were collected. The patients were divided into 2 groups according to the treatment they received： conventional parotidectomy or modified parotidectomy. Postoperative deformity, facial paralysis and Frey＇s syndrome in each group were observed and analyzed. Results： All of the patients were followed up for at least 1 year. The incidence of facial paralysis in the modified parotidectomy group was significantly lower than that in the conventional parotidcctomy group at 3.5 months after the surgery （P〈0.05）. No significant difference was found in the incidence of paralysis between the two groups 1 year after the surgery （P〉0.05）. The patients in the modified parotideetomy group appeared to have good aesthetic contour, without obvious scars and with a lower incidence of Frey＇s syndrome. Conclusion： Modified parotidectomy ean effectively reduce postoperative complications and it bas advantages over conventional parotidectomy.