腮腺良性肿瘤的美容功能性术式临床应用

The clincal application of surgical treatment focusing on cosmetic and functional approact for the bening parotid tumors

目的:探讨通过改良术式提高腮腺良性肿瘤手术的美容效果和功能的恢复。方法:手术治疗腮腺良性肿瘤47例,术式中对切口位置、SMAS腮腺筋膜瓣和胸锁乳突肌瓣的应用、保留导管的腮腺区域性切除、面神经及耳大神经的保护、腮腺残端及创区的处理等方面作了相应改良。并对术后美容效果和功能的恢复进行3～18个月的随访检查。结果:术后颌面部切口隐蔽瘢痕不明显,腮腺区外形良好,无凹陷畸形,无涎瘘和Frey氏综合征,耳垂和耳廓背部皮肤感觉功能及腮腺分泌功能基本正常。患者对面容和功能的恢复均较满意,未见肿瘤复发。结论:改良的腮腺肿瘤术式提高了手术的整体质量,取得了较好的美学和功能效果。

Objective This article delves into the improved operation to enhance the cosmetic effect and functional recovery resulted from the surgical treatment for the patients suffering benign parotid tumors. Methods 47 patients were under the surgical treatment for the benign parotid tumors. The operation had been improved in following aspects： incision position,the application of SMAS parotid fascia flaps and sternocleidomastoid muscle flaps,partial parotid excision except catheter,preserving facial and major auricular nerve, parotid stump and wound management. We followed up cosmetic effect and functional recovery with patients for 3-18 months. Results The concealed scar on jaw or face resulted from incision is not clear after operation. The appearance of parotid keeps well without sunken deformation, salivary fistula and Frey＇s syndrome. Both the skin sensory function of earlobe and auricle backside and parotid secretion function were normal basically.All patients are satisfied with the recovery of facial features and function. No tumors recur. Conclusion The improvement of operation for parotid tumors enhances the whole quality of surgical treatment, which make the achievements of better aesthetical and functional effect.