胸锁乳突肌瓣转移术在腮腺切除术中的应用

Sternocleidomastoid muscle flap transfer for the application in parotidectomy

目的探讨胸锁乳突肌肌瓣即刻修复腮腺肿瘤术后面部凹陷畸形和减少术后味觉出汗综合征(Frey综合征)发生的临床效果。方法选择2002年3月至2009年3月腮腺肿瘤住院手术患者97例,分为试验组67例、对照组30例。试验组患者按常规"S"切口施行腮腺肿瘤加腮腺浅叶或全叶切除术,同期行胸锁乳突肌肌瓣转移修复术;对照组则不行同期肌瓣修复,经随访对比观察1～5年。结果对照组局部凹陷畸形发生率为86.7%(26/30),Frey综合征发生率为66.7%(20/30);试验组局部凹陷畸形发生率为17.9%(12/67),Frey综合征发生率为9.0%(6/67),两组间差异有统计学意义(P<0.01)。结论胸锁乳突肌肌瓣转移修复术是一种即刻修复腮腺肿瘤术后面部凹陷畸形和降低Frey综合征发生率的较好方法。

Objective To explore the clinical immediate reconstruction effect of sternocleidomastoid myocutaneous flap on facial depression deformity and postoperative gustatory sweating syndrome （Frey syndrome） after parotid gland tumor surgery.Methods From March 2002 to March 2009,97 cases were divided into experimental group of 67 cases,control group of 30 cases.Patients in experimental group were performed with the usual ＂s＂ incision to remove parotid gland tumor,combined with resection of superficial lobe or the whole leaf,then sternocleidomastoid myocutaneous flap repair was performed,but sternocleidomastoid myocutaneous flap repair was not performed in patients in control group.All the patients had been followed-up for 1 to 5 years.Results The local depression deformity rate and incidence of Frey syndrome were 86.7% （26/30） and 17.9% （12/67）,66.7% （20/30） and 9% （6/67） in experimental group and control group,with statistically significant differences between the two groups （P0.01）.Conclusion Sternocleidomastoid myocutaneous flap surgery is an instant repair for facial depression deformity after parotid gland tumor surgery,and can reduce the incidence of Frey Syndrome.