改良术式手术切除腮腺良性肿瘤的临床应用

The clinical application of modified surgical procedure in removal of parotid benign tumors

目的探讨改良术式在手术切除腮腺良性肿瘤的临床效果及可行性。方法对36例腮腺良性肿瘤首发病例(肿瘤直径均≤3.0 cm),根据肿瘤发生部位,选择不同切口,采用保留腮腺主导管的肿瘤+区域性腮腺切除术+局部面神经解剖术的改良术式。术后随访6个月～3年,观察患者术后肿瘤有无复发,并发症发生等情况;测定每个病例手术前后总唾液量,评价术后腮腺分泌功能。结果 36例患者术后切口均一期愈合,肿瘤术后无复发,未出现涎瘘、Frey综合征、口干。1例患者术后出现暂时性面瘫,于2周左右恢复正常。术前唾液总量为(6.6±0.76)ml/6 min,术后唾液总量为(6.2±0.82)ml/6 min,手术前后唾液总量差异无统计学意义(P<0.05)。结论改良术式手术切除腮腺良性肿瘤,术后肿瘤无复发,并发症少,术后腮腺分泌功能良好。

Objective To investigate the clinical efficacy and feasibility of modified procedure in removal of parotid benign tumors.Methods Thirty-six patients with parotid benign tumor（tumor diameter ≤ 3.0cm） underwent regional parotidectomy including tumor plus facial neuroanatomy and Stensen’s duct was maintained.Different incisions were selected according to the tumor locations.The patients were followed up for 6 months to 3 years to observe recurrence rate of tumors and post-operational complications.The pre-operational and post-operational total salivary volume was collected to investigate secretory function of the parotid.Results All of 36 patients with postoperative incision were healed without recurrence.No salivary fistula,Frey’s syndrome and dry mouth occurred in all patients.There was one case of postoperative temporary facial paralysis,which returned to normal in about two weeks.The pre-operational and post-operational total salivary volume was（6.6±0.76）ml and（6.2±0.82）ml in 6 minutes’ chewing paraffin wax without statistical significance（P＆lt;0.05）.Conclusion The modified surgical procedure is an effective surgical method to remove parotid benign tumors with lower postoperative tumor recurrence,fewer complications and good post-operational secretory function of parotid.