腮腺肿瘤术后面神经功能损伤的多因素分析

An analysis of factors for facial nerve paralysis after surgical treatment for parotid tumour

目的：探讨腮腺肿瘤术后面神经功能损伤的发生率与手术方式、面神经解剖方式、病变性质、肿瘤位置以及手术次数等关系。方法：对本院2001年3月-2007年7月手术治疗的264例腮腺区病损患者的临床资料进行回顾性分析。结果：264例患者中有127例（占48%）术后出现面神经功能损伤。行浅叶及肿瘤切除手术比行全叶及肿瘤切除手术损伤面神经的概率低。良性肿瘤术后面神经损伤的机会较恶性肿瘤低,多次手术较首次手术发生损伤面神经的概率低,耳前、下颌骨后侧较耳后及耳下发生损伤面神经的概率高,良性病损术后多为暂时性面神经损伤;恶性病损,由于采用切除受累神经分支术式,术后面神经损伤多为永久性的。结论：面神经受损的危险性与手术切除范围、面神经解剖方式、病理性质、肿瘤位置及手术的次数等是密切相关的。

Objective： To explore the relationship between the rate of facial nerve paralysis and the parotid anatomy methods, different surgical methods, pathological diagnosis, the place that tumor lies and the operation time. Methods： The records of 428 patients with parotid tumours, who were treated from March 2001 to July 2007 at our department, were retrospectively analysed. Results： One hundred and twenty-seven cases of them complicated with facial nerve paralysis and were about 48%. There were higher rate with facial nerve paralysis in totalparotidectomy than segmentary parotidectomy or superficial parotidectomy. Higher rate in benign tumor than in malignant tumor. Higher rate in several times than in first time. Higher rate in tumor before auris and behind mandble than that behind and under auris. Facial nerve paralysis were often temporary in benigon tumor, but were forever in malignancy because tumor invaded facial nerve. Conclusion： There were closely relationship between facial nerve paralysis and operation, the parotid anatomy methods, different surgical methods, pathology diagnosis, the tumor location and the operation times.