内镜辅助耳后发际入路上颈良性肿物切除术

Endoscope-assisted removal of upper neck benign masses via retroauricular hairline incision

目的探讨内镜辅助耳后发际入路上颈良性肿物切除的可行性、指征和利弊。方法采用内镜辅助耳后发际入路对18例上颈良性肿物行手术治疗。术前行影像学(CT或MRI)评估病损大小、位置、毗邻,并行细针穿刺组织学活检明确病理。结果 18例患者均顺利完整切除肿物。术后2例(11.1%)出现暂时性耳垂麻木,1例(5.6%)出现暂时性面神经下颌缘支麻痹。所有病例无术后出血、无皮瓣坏死、无涎瘘等,随访6～18个月(平均12个月),未见复发。术后1个月所有患者客观美容满意度评分平均9.6分,对手术美容效果满意。结论内镜辅助耳后发际入路上颈良性肿物切除术安全、可行,优点切口隐蔽、美容效果确切、无明显并发症,是一种可供临床借鉴的美容术式。

[Objectives] To assess the feasibility,the indications,the risks and benefits of endoscope-assisted removal of upper neck benign masses via the restroauricular hairline incision （RAHI）.[Methods] Eighteen patients with benign masses of upper neck underwent endoscope-assisted excision via the RAHI approach.Preoperatively,sizes,locations and adjacency of all lesions were evaluated by imaging （CT or MRI）.Pathologic diagnosis of all cases were identified as benign diseases by fine needle aspiration biopsy.[Results] All 18 operations were successfully performed with complete removal of the upper neck masses.2 cases （11.1%） with temporary numbness of earlobe and 1 case （5.6%） with temporary marginal mandibular nerve paralysis were found postoperatively.There were no postoperative hemorrhage,flap necrosis,salivary fistula and so on.All the l8 patients were disease free with a follow-up from 6 months to 18 months （average 12 months）.The mean subjective satisfaction score was 9.6 and all the patients were satisfied with the cosmetic results.[Conclusion] Endoscope-assisted removal via RAHI is feasible and safe for upper neck benign masses.This approach can provide an invisible incision and exact cosmetic results without significant complications.This method may be an alternative option for patients with upper benign masses.