腺体保存术在下颌下腺良性肿瘤治疗中的应用

Utilization of gland-preserving surgery in the treatment of benign submandibular gland tumor

目的将包括肿瘤在内的整个下颌下腺完全摘除是目前下颌下腺良性肿瘤的主要手术方式。本文旨在探讨腺体保存术在下颌下腺良性肿瘤治疗中的应用并对其疗效进行评估。方法将于2007年1月至2008年12月期间我科收治的40名下颌下腺良性肿瘤患者随机分组,分别实施行腺体完全摘除或腺体部分保留手术,对比评估两组患者的手术时间、神经损伤情况、术后腺体功能、术后外貌及复发率。结果相对于腺体完全摘除组,腺体保存组患者的术后神经损伤少、颌下区凹陷畸形轻,且术后腺体分泌功能及患者的满意度均明显提高;术后随访38个月到5年,两组患者均无复发。结论相对于传统的腺体完全摘除术,腺体保存术具有神经损伤小、颌下区凹陷轻、腺体功能及患者满意度明显提高等多种优点,可以成为下颌下腺良性肿瘤的首选手术方式。

Objective Complete removal of submandibular gland including the tumor is the main operation method of benign submandibular gland tumors. This paper aims to establish a gland-preserving operation for benign tumors of the submandibular gland and evaluate its efficacy. Methods 40 patients with benign submandibular gland tumors treated in our department from January 2007 to December 2008 were randomly divided into two groups： the gland was completely removed in one group and partially preserved in the other one. Duration of operation,extent of injury to the nerve,postoperative function of the gland,aesthetic appearance,and recurrence of the two groups were assessed and compared. Results There was no significant difference in baseline characteristics among patients in two groups. The extents of injury to the nerve,together with deformities of the facial contour,were significantly less in the group in which the gland was preserved than in which the gland was completely removed. Postoperative gland secretive function and overall patients＇ satisfaction were better in the former group. There was no recurrence in either group during the follow up period of 38 months-5years. Conclusion The gland-preserving procedure has advantages over the typical approach in which the gland is sacrificed. There is less risk of injury to the nerve,less deformity of the facial contour,and better preservation of gland function,and patients are more satisfied. The gland-preserving technique can therefore be the first choice for management of benign submandibular tumors.