腮腺浅叶区域切除术治疗腮腺浅叶多形性腺瘤的效果评价

Effect of partial superficial parotidectomy in treatment of pleomorphic adenoma in superficial lobe of parotid

目的：探讨腮腺浅叶区域切除术治疗腮腺浅叶多形性腺瘤的临床效果。方法回顾性分析2010年1月到2015年12月的腮腺浅叶的多形性腺瘤的患者，采用保留面神经、部分或完整保留腮腺导管和腮腺筋膜的腮腺浅叶区域切除术，总结其治疗效果和并发症。结果109例患者符合且愿意回访，其平均手术时间0.5-1.5 h，出血量在20-100 ml，13例出现暂时性面瘫、2-6个月即恢复正常，无永久性面瘫，4例出现涎瘘，5例3个月后出现主观Frey’s综合征、11例出现客观Frey’s综合征，80例出现耳廓以及耳周麻木、3-6个月即恢复正常，无肿瘤复发，腮腺分泌功能未受影响。结论腮腺浅叶区域切除术创伤小，并发症少，还可以保存腮腺一定的功能，可作为直径未超过3 cm腮腺多形性腺瘤临床治疗的首选术式。

Objective To investigate the clinical effect of partial superficial parotidectomy in the treatment of pleomorphic adenoma in superficial lobe parotid. Methods The clinical data of patients with pleomorphic adenoma in superficial lobe of parotid between January 2010 and December 2015 were retrospectively analyzed. All patients underwent partial superficial parotidectomy with retained facial nerve , partial or complete retained parotid duct and parotid fascia. The treatment effect and complications were evaluated. Results A total of 109 patients fullfilled the inclusion criteria,and were willing to rehospitalize. The mean operation time was 0.5-1.5 h. The blood loss was 20 to 100 ml. Thirteen cases developed temporary facial paralysis,which returned to normal after 2-6 months. There was no permanent facial paralysis. There were 4 cases of salivary fistula,5 of Frey’s syndrome at 3 months,11 of objective Frey’s syndrome,and 80 of numbness at auricle and around ear,which returned to normal after 3-6 months. There was no tumor recurrence. The secretory function of parotid was not affected. Conclusion Partial superficial parotidectomy shows less surgical trauma and complications,with the function of saving parotid. It can be used as the primary option for treatment of parotid pleomorphic adenoma with diameter less than 3 cm.