改良腮腺良性肿瘤切除术的美学效果

Esthetic Exploration of the Modified Parotidectomy of Benign Tumor

目的:探讨改良功能性腮腺良性肿瘤切除术的临床效果和美学效果。方法:收集32例腮腺良性肿瘤病例,采用腮腺美容切口、保留耳大神经、腮腺区域性切除和SMAS筋膜填塞(或植入脱细胞真皮基质)等改良腮腺良性肿瘤切除术,随访6～24个月,通过问卷调查患者面部外形满意度、腮腺区味觉出汗症状和术区感觉恢复情况,临床检查和淀粉碘试验评价面部外形、面神经功能和Frey's综合征。结果:术后切口均Ⅰ期甲级愈合,随访6～24个月,腮腺区外形良好,凹陷畸形不明显。28例面神经功能评价为House-Brackmann分级Ⅰ级,4例为II级;3例术侧耳垂麻木,术后3～8个月触觉、痛觉和温度觉逐渐恢复;1例出现Frey's综合征;术后美容效果满意率100%。结论:应用改良腮腺良性肿瘤切除术尽可能保留了术后腮腺功能,有效减少了术后多种并发症的发生,获得了良好的美学效果。

Objective To evaluate the clinical outcome and esthetics effect of the modified parotidectomy of benign tumor. Methods This study reviewed 32 patients with benign parotid tumor. Parotidectomy was designed and modified as follows： using a facial esthetical incision; preservation of great auricular nerve in parotidectomy; application of regional excision of parotid gland; repairing parotid bed with SMAS fold flaps or implanting with ADM. All 32 patients were evaluated via a short questionnaire regarding as perception of a facial contour deformity,Frey＇s syndrome,Minor＇s starch- iodine test,and clinical examination. Results All the patients showed results with no obvious scar and sunken deformity left in face and submandibular region. The facial nerve functional evaluation in 28 cases were grade I and 4 were grade II. 3 patients felt numb in ear lobe and the symptom was disappeared in 3N8 months post-operation. One patient has presented with clinical Frey＇s syndrome.Aesthetic results were extremely satisfactory. Conclusion The modified parotidectomy is a function-preserving surgery for benign parotid tumors,which improves the cosmetics and reduces complications.