腮腺部分切除术在腮腺浅叶下极良性肿瘤中的临床价值

Clinical value of partial parotidectomy for benign tumor in posterior-inferior part of parotid superficial lobe

目的探讨腮腺部分切除术在腮腺浅叶下极良性肿瘤手术中的临床应用价值。方法回顾性研究2003年5月～2008年9月我院治疗的腮腺浅叶下极良性肿瘤患者127例,其中采用腮腺部分切除术48例,采用传统的腮腺浅叶切除术79例。所有患者随访1～5年,对比其并发症的发生率及肿瘤复发情况。结果腮腺浅叶切除术组面部畸形明显,暂时性面瘫发生率为17.7%(14/79),味觉出汗综合征(Frey综合征)发生率为44.3%(35/79),唾液瘘发生率2.5%(2/79)。腮腺部分切除术组患者术区面部畸形较轻,暂时性面瘫发生率为4.2%(2/48,P<0.05),Frey综合征发生率为10.4%(5/48,P<0.05),本组无唾液瘘发生。两组患者随访期间均无肿瘤复发。结论腮腺部分切除术具有手术创伤小、并发症少、术后面部畸形小等优点,是腮腺浅叶下极良性肿瘤治疗的理想术式。

OBJECTIVE To investigate the clinical value of partial parotidectomy in treatment of benign tumor in posterior-inferior part of parotid super？cial lobe. METHODS The clinical data of 127 patients with benign tumors in posterior-inferior part of parotid super？cial lobe who were performed operation in our department from 2003.05 to 2008.09 were retrospectively studied. The patients were divided into two groups. Group one with 48 cases were treated with partial parotidectomy, group two with 79 cases were treated with excision of superficial lobe. All patients were followed up for 1 to 5 years to investigate on the facial outline, the complication rates and the local recurrence. RESULTS Facial malformation was slight in group one and obviously in Group two. The rates of transient facial paralysis and Frey＇s syndrome were signi？cantly reduced in group one compared with that in group two（4.2% vs 17.7%; 10.4% vs 44.3%, P〈 0.05）. There were 2 cases with salivary fistula in Group two and no tumor recurrence in both group during follow-up. CONCLUSION The partial parotidectomy is with advantages of minimally invasive, less complications and better cosmetic outcome and is an ideal operative method for benign tumor in posterior-inferior part of parotid super？cial lobe.