包膜外切除术治疗腮腺沃辛瘤的临床观察

Effects of extracapsular dissection in treatment of Warthin tumors

目的探讨应用包膜外切除术作为腮腺沃辛瘤治疗常规术式的合理性。方法 2005年5月—2009年2月42例腮腺沃辛瘤患者行包膜外切除术(伴或不伴面神经解剖)治疗,对手术入路及切除范围进行改良,随访术后面瘫、面部畸形、Frey′s综合征(味觉出汗综合征)等并发症的发生情况。结果全部病例完整切除病变,仅2例出现术后暂时性面瘫,3个月后面瘫症状消失。术后瘢痕隐蔽,面侧区凹陷畸形不明显,面容影响小。全部病例无Frey′s综合征的发生。1例患者随访8个月后同侧腮腺下极出现肿瘤,再次手术切除,病理证实仍为沃辛瘤。结论腮腺沃辛瘤行包膜外切除术治疗可以简化手术操作,减少并发症的发生,不会增加肿瘤复发的几率,手术结果令人满意。

Objective To evaluate the feasibility of extracapsular dissection in treatment of Warthin tumors.Methods 42 patients with Warthin tumor were treated with extracapsular dissection from May 2005 to February 2009.Postoperative deformity and Frey′ s syndrome were observed and analyzed.Results A total of 42 tumors were removed by local extracapsular dissection.The patients appeared to have good aesthetic contour,without obvious scars and with a lower incidence of facial nerve dysfunction.Frey′s syndrome did not occur in all cases.There were no recurrences with a follow-up of 10 to 55 months,except one reappearance 8 months after operation.Conclusions This series shows that extracapsular dissection is a safe and effective method of removing Warthin tumors.