腮腺良性肿瘤的外科手术治疗方式及其并发症分析

Analysis on the surgical methods and complications of benign parotid neoplasms

目的 回顾性分析腮腺良性肿瘤的外科手术治疗方式的选择及其并发症.方法 收集我院2007-2011年间83例腮腺良性肿瘤患者,行腮腺部分切除术21例,腮腺浅叶切除术43例,全腮腺切除术19例,随访1～4年,分析其手术效果及并发症.结果 在本组病例中,均无肿瘤复发及永久性面瘫;在腮腺部分切除术中,暂时性面瘫发生率为14.3％ （3/21）,Frey综合征为4.8％ （1/21）.在腮腺浅叶切除术中,暂时性面瘫为39.5％ （17/43）,涎瘘为14％ （6/43）,Frey综合征为16.3％ （7/43）.在全腮腺切除术中,出现暂时性面瘫发生率为52.6％ （10/19）,涎瘘为10.5％ （2/19）,Frey综合征为15.7％ （3/19）.结论 腮腺部分切除术并发症少,但有严格的手术适应证,腮腺浅叶切除术手术疗效肯定,但并发症较多,术中尽量保护面神经,保留腮腺导管、耳大神经.全腮腺切除术术后暂时性面瘫发生率最高.三种术式均有严格的适应证,不同部位的腮腺肿瘤应采用不同的手术切除方式,以减少并发症的发生.

Objective To evaluate the different treatment outcomes and complications of benign parotid tu- mour. Methods A retrospective study was carried out among 83 patients with benign parotid tumors treated surgical- ly in our hospital from 2007 to 2011. All the patients were followed up for I--4 years. The complications and treat- ment outcomes were analyzed. Results There was no tumor recurrence and permanent facial paralysis. In the cases of partial parotidectomy, the incidences of temporary facial paralysis and FreT syndrome were 14.3% and 4.8%, re- spectively. In the cases of superficial parotidectomy, the incidences of temporary facial paralysis, gland fistula and FreT syndrome were 39.5%, 14% and 16.3%, respectively. In the cases of total parotidectomy, the incidences of tempo- rary facial paralysis, gland fistula and FreT syndrome were 52.6%, 10.5% and 15.7%, respectively. Conclusion Par- tial parotidectomy can reduce postoperative complications, but it has strict surgical indications. Superficial parotidecto- my results in good treatment outcomes, but the incidence of complications is high. During the operation, facial nerve should be protected, and the Steven＇s duct, the greater auricular nerve should be preserved. After total parotidectumy,the incidence of temporary facial paralysis is the highest. In a nutshell, the three surgical methods should be chosen ac- cording to the tumor location, in order to reduce the postoperative complications.