腮腺良性肿瘤部分切除术的临床探讨

Partial parotidectomy in the treatment of parotid benign tumors

目的观察腮腺良性肿瘤部分切除术与传统腮腺浅叶切除术术后并发症的比较,探讨部分切除术的合理性。方法选择腮腺浅叶良性肿瘤患者103例,其中53例采用腮腺部分切除术治疗,在距肿瘤边界0.5-1.0 cm处的正常腺体内切除肿瘤,保留腮腺咬肌筋膜、耳大神经分支。50例采用传统腮腺浅叶切除术。随访0.5~5年,观察并比较（卡方检验）2组并发症的发生率及肿瘤复发情况。结果腮腺浅叶良性肿瘤部分切除术术后较少出现面部畸形,腮腺功能良好,相对于传统腮腺浅叶切除术组,Frey综合征、口干、耳垂区麻木以及术后暂时性面瘫、涎瘘等术后并发症发生率均明显减少（P〈0.05）。2组患者术后肿瘤均无复发。结论腮腺浅叶良性肿瘤部分切除术既能保证腮腺良性肿瘤彻底切除,又可以显著减少各类手术并发症。

Objective To discuss the clinical effects and rationality of partial parotidectomy in the treatment of parotid benign tumors. Methods Among 103 cases of parotid benign tumors,53 cases were treated with partial parotidectomy. The ectomy field was extended 0.5-1.0 cm from the border line of tumor,with conservation of fascia parotideamasseterica and branch（s） of great auricular nerve; the other 50 patients were treated with conventional superficial parotidectomy. All the patients were followed up for 0.5-5 years. The differ- ences in the incidence of complications and tumor recurrence between the 2 groups were compared by using Chi-square tests. Results The degree of facial deformity was mild,and the function of parotid was fine after partial parotidectomy. The occurrence rates of Frey syn- drome,xerostomia,earlobe numb,facial deformity,temporary facioplegia and salivary fistula in the partial parotidectomy group were signifi- cantly （P 〈 0.05） lower than the superficial parotidectomy group. Tumor recurrence was not observed in both groups. Conclusions Par- tial parotidectomy can completely resect the parotid benign tumors,and significantly decrease the occurrence rate of complications.