54例下颌下腺肿物切除手术的临床分析

A clinical analysis of submandibular gland mass excision in 54 cases

目的探讨下颌下腺肿物切除的手术要点及临床疗效。方法对2011年1月-2014年1月本院收治的54例下颌下腺区肿物的患者行下颌下腺腺体及肿物切除术，对于病理回报为恶性肿瘤的患者同期行Ⅰ、Ⅱ、Ⅲ区淋巴结清扫术。术后随访12～24个月，观察治疗效果。结果54例患者均完整切除下颌下腺腺体及肿物，其中面神经下颌缘支暂时眭损伤2例，感染1例，术后病理回报淋巴结转移2例，无舌下神经、舌神经损伤病例，无复发病例。结论下颌下腺区肿物切除术中，神经分支的保护，层次清楚的局部解剖和严密止血是保证手术成功的关键。

Objective To discuss the key surgical points and therapeutic effect of submandibular gland mass excision. Methods 54 patients suffering from submandibular gland mass and hospitalized in our department from Jan 2011 to Jan 2014 were included. All patients received excision of submandibular gland and mass, and those with malignant pathological results underwent neck lymph dissection of I , II and III regions. All the patients had been followed up for 12 to 24 months postoperatively and their therapeutic effect was observed. Results Total excision of submandibular gland and mass was achieved in all the patients. Temporary injury of submandibular branch of facial nerve occurred in 2 cases, and infection occurred in one. Postoperative pathological examination revealed lymphatic metastasis in 2 cases. Injury of subglossal nerve or glossal nerve occurred in none. No recurrence occurred. Conclusion Protection of nerve branches, clear local anatomy and careful hemostasis are essential for successful excision of submandibular mass.