耳后隐蔽切口入路切除腮腺下极良性肿瘤疗效评价

Removal of benign tumor in the lower pole of the parotid gland through concealed incision in the retroauricu-lar sulcus

目的采用耳后隐蔽切口对腮腺下极小型良性肿瘤实施切除,探讨该手术入路安全性及可行性,为腮腺良性肿瘤切除手术的美学考虑提供新思路。方法18例腮腺下极良性肿瘤患者,均采取耳后隐蔽切口行腮腺肿瘤切除术,其中多形性腺瘤9例,肌上皮瘤2例,Warthin瘤5例,基底细胞腺瘤1例,嗜酸细胞瘤1例。术后3个月随访面瘫、涎瘘情况,采取视觉模拟量表对手术切口外观进行满意度评分。术后6~12个月随访肿瘤复发情况。结果18例腮腺下极良性肿瘤,肿瘤直径1.0~3.1 cm,平均2.5 cm。所有患者均可通过耳后隐蔽切口顺利完成手术,术后伤口均一期愈合。术后3个月均未出现永久性面瘫及肿瘤复发等严重并发症。患者对外观较满意(美学评分9.3±0.4),达到预期美容效果。结论耳后隐蔽切口对于腮腺下极、颌后区的小型良性肿瘤是一种安全可行的手术入路,因手术瘢痕主要位于耳后沟内,较好满足了患者术后美观的需求。

Objective To assess the safety and feasibility of incision in the retroauricular sulcus for removal of be-nign tumors in the lower pole of the parotid gland and to provide some ideas for aesthetic consideration of parotidecto-my.Methods In total,18 cases with benign tumors of the lower pole regions of the parotid gland were included in this study,including 9 pleomorphic adenomas,2 myoepitheliomas,5 Warthin tumors,1 basal cell adenoma and 1 oncocyto-ma.Three months after the operation,facial paralysis and salivary fistula were assessed.A visual analog scale was used to score the cosmetic satisfaction of the surgical incision.Tumor recurrence was followed up 6~12 months after opera-tion.Results In 18 patients with benign tumors the lower pole regions of the parotid gland,the tumor diameter ranges from 1.0 to 3.1 cm,with an average value of 2.5 cm.All patients experienced successful complete removal of the parotid mass with the minimally invasive retroauricular approach,and all wounds healed in one stage after operation.No serious complications,such as permanent facial paralysis and tumor recurrence,occurred 3 months after the operation.The pa-tients were satisfied with the appearance of the surgical incision(aesthetic score 9.3±0.4),achieving the expected aes-thetic effect.Conclusion This approach is feasible and safe for most small benign parotid tumors located in the lower pole region of the parotid gland and in the posterior region of the jaw.The scar is located in the retroauricular sulcus,which significantly meets the aesthetic needs of the concealed incision for patients.