改良腮腺部分切除术在老年腮腺下极良性肿瘤中的临床应用

Clinical application of modified partial parotidectomy in treatment of aged patients with benign tumor located in lower parotid gland

目的:探讨改良腮腺部分切除术在老年腮腺良性肿瘤手术中的临床应用价值。方法:回顾性地研究2005年8月-2010年10月我院治疗的老年腮腺下极良性肿瘤患者86例,其中,采用改良腮腺部分切除术患者37例,采用传统的腮腺浅叶切除术患者49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:采用腮腺浅叶切除术组面部畸形明显,暂时性面瘫发生率为20.4%(10/49),味觉出汗综合征发生率为40.8%(20/49),涎瘘发生率4.1%(2/49);采用改良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5.4%(2/37),味觉出汗综合征发生率为8.1%(3/37),P<0.05,本组无涎瘘发生;2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,是老年腮腺下极良性肿瘤治疗的理想术式。

Objective： To investigate the clinical application of modified partial parotidectomy in treatment of aged patients with benign tumor located in lower parotid gland. Methods： Eight-six cases with benign tumors located in lower parotid gland who performed operation in our department from 2005.08 to 2010.10 were retrospectively studied Forty-nine cases were treated with excision of superficial lobe （group [ ）, and 37 cases were treated with modified partial parotidectomy （group II ）. All patients were followed up for 1-5 years to investigate the facial outline and the rates of complication and recurrence. Results.. Facial malformation in group I was obviously, and slight in Group Ⅱ. The rates of transient facial paralysis and Frey＇s syndrome in group Ⅱwere significantly lower than in group I （20.4% vs 5.4% ; 40.8% vs 8.1%, p〈0.05）. Two cases of salivary fistula were found in group I , but not found in group ⅡThere was no tumor recurrence in both groups during follow-up time.Conclusions： Modified partial parotidectomy is an ideal operative method for aged patients with benign tumor located in lower parotid gland with the advantage of less trauma and complications and better cosmetic outcome.