腮腺良性肿瘤手术术式的美学改良:美容切口和胸锁乳突肌瓣的应用

Clinical utilization of veiled incision and sternocleidomastoid flap in parotidectomy of parotid benign tumors

目的:在腮腺良性肿瘤手术中应用耳屏内联合耳后发际切口及胸锁乳突肌瓣修复术区凹陷畸形,探讨其临床应用效果。方法:46例患者分为2组,一组行美容切口并用胸锁乳突肌瓣修复术区凹陷,另一组行传统"S"形切口未做胸锁乳突肌瓣修复;术后随访2a。临床检查暂时性面瘫、涎瘘和术后肿瘤复发,问卷调查Frey综合征、耳垂区麻木、面部瘢痕及畸形情况。采用SPSS13.0软件包对数据进行统计学分析。结果:美容切口及胸锁乳突肌瓣修复术区后美学效果显著优于传统术式,术后暂时性面瘫、涎瘘和术后肿瘤复发率无显著差异。结论:美容切口较传统切口隐蔽、美观,胸锁乳突肌瓣修复对术区凹陷畸形有明显改善。

PURPOSE： To describe a modified technique of parotidectomy using face-lift approach and sternocleidomastoid flap. METHODS： Forty-six patients were divided into two groups; group 1 （23 cases） using veiled incision and sternocleidomastoid flap, group 2 （23 cases） using traditional incision （Blair’s approach） without sternocleidomastoid flap. Postoperative complications included temporary facial paralysis and salivary fistula. The follow-up period was 2 years, oncological recurrence was compared between the two groups. The incidence of Frey’s syndrome and the feeling of the region around the auricular lobule were evaluated. The data was analyzed using SPSS10.0 software package with Student’s t test and Chi-square test. RESULTS： During the follow up period, the patients in the group 1 showed better aesthetic results than those in the group 2 and without obvious scar and deformity. There was no significant difference between these two groups in temporary facial paralysis, salivary fistula, tumor recurrence, Frey’s syndrome, the feeling of the region around the auricular lobule. CONCLUSION： The modified technique of parotidectomy using veiled incision and sternocleidomastoid flap greatly reduces the disadvantages of traditional parotidectomy and provides better aesthetic results. Supported by Science and Technology Projects of Shanxi Province （Grant No.2009K17-03）,Science Project of Education Department of Shanxi Province（09Jk712） and Foundation of Xi’an Science and Technology Projects[Grant No.SF08008-（4）, SF09030（4）].