腮腺良性肿瘤手术不同美容切口的选择

Different cosmetic incision selection in parotidectomy

目的根据腮腺肿瘤的性质、位置、大小选择相适应的不同美容切口，并探讨腮腺肿瘤手术的最适美容切口选择方法。方法将南昌大学第一附属医院颌面外科2015年至2017年收治的33例腮腺良性肿瘤患者按肿瘤的位置、大小采用不同的美容切口进行手术，包括腮腺耳屏前垂直切口、耳屏前拐杖切口及除皱切口。术中注意保护面神经及耳大神经。术后检查暂时性面瘫、涎瘘以及术后外观情况，并与传统手术切口入路的21例患者进行比较。结果共随访6～12个月。采用腮腺美容切口患者术后满意度高于传统组，差异具有统计学意义（P〈0．05），而暂时性面瘫、涎瘘的发生率与传统手术切口比较，差异无统计学意义（P〉0．05）。结论应根据腮腺肿瘤的位置选择合适的美容切口入路，术后患者有较满意的面部外形，较传统手术切口有其优越性。

Objective Based on the nature, location and size of parotid tumor, different incisions were chosen and method of selecting the best cosmetic incision for parotid gland tumor operation would be discussed. Methods 33 cases of parotid benign tumor patients that received by Department of Oral and Maxillofacial surgery of First Affiliated Hospital of Nanchang University during 2015 - 2017 were included in this study. According to the size of the tumor location, different incisions, mainly pretragal vertical, pretragal crutch and rhytideetomy incision were selected. The facial nerve and the great auricular nerve were protected during the operation. In 1-month and 3-month follow-up, clinical examination of temporary facial paralysis, salivary fistula, especially the cosmetic outcome after the surgery were evaluated. Results The satisfaction rate of parotid cosmetic incision was significantly higher than that of the traditional group, the incidence of transient facial paralysis, salivary fistula was not statistically significant compared with the traditional incision. Conclusions According to the location of parotid tumor, we should choose the proper cosmetic incision approach, which is better than the traditional surgical incision.