面神经解剖在腮腺手术中的临床意义

Clinical signification of facial nerve anatomy in parotid operation

目的:探讨面神经解剖在腮腺肿瘤切除术中的意义。方法:回顾性分折1998～2005年我科施行腮腺肿瘤切除术101例。面神经解剖86例(85.1%,86/101)。面神经总干解剖15例,面神经下颌缘支解剖71例。3例恶性肿瘤和12例小腺瘤未行面神经解剖。腮腺局部切除12例,腮腺浅叶切除74例,腮腺全切除15例。结果:全组术后随访9～33个月,无肿瘤复发病例。4例术后腮腺瘘,7～10d痊愈。1例永久性面瘫。无术后出血、感染等并发症。结论:面神经解剖有助于完整切除腮腺肿瘤和防止面神经医原性损伤。美蓝染色可在术中有效识别面神经。

Objective：To study the signification of facial nerve anatomy during parotid operation. Methods：This paper was to summarize and analyze retrospectively the clinical experience of 101 cases with the parotid-tumor who were performed operation from 1998 to 2005. Of these 101 cases, facial nerve were anatomized in 86 cases （85.1%,86/101）,including facial nerve con-caudex anatomy in 15 cases, ramus marginal mandibulae nervous facial anatomy in 71 cases. Malignant tumor in 3 cases and little adenoid tumor in 12 cases weren＇t facial nerve anatomy. Based on demand of the treatment, parotid local excision in 12 cases, parotid superficial-lobe excision in 74 cases and parotid total excision in 15 cases were performed. Results： Followed-up all of patients for 9-33 months, postoperatively, no one recurrence. Fistula of parotid gland occurred in 4 cases and 7-10 days were healed through changing dressing and permanence facial palsy in 1 cases and no post-operative complications such as blooding or infection were observed. Conclusion：It is one of effective measures in parotid oper- ations with facial nerve anatomy for preventing facial nerve iatrogenic damage. Methylene blue is helpful to discriminate facial nerve.