面部美容手术致腮腺损伤的原因及防治

Causes and prevention and treatment of parotid gland injury caused by facial cosmetic surgery

目的分析面部美容手术致腮腺损伤的原因并提出预防措施。方法回顾性分析自2013年5月至2019年5月,北部战区总医院烧伤整形外科收治的11例因面部美容手术致腮腺损伤的患者,其中除皱术后4例,线雕术后4例,脂肪填充术后2例,颊脂垫取出术后1例。分析其形成原因,并提出预防措施。结果11例患者中,7例通过保守治疗在1周内包块消失;4例通过手术治疗,伤口均一期愈合。随访3个月,所有患者均保留腮腺的分泌功能、面部肌肉和面部形态恢复良好,患者对治疗效果和外观均满意,均未出现复发。结论面部美容手术致腮腺损伤主要是由于术者对局部解剖不熟悉或手术操作粗暴造成,加强术者的局部解剖学培训对防止腮腺损伤至关重要。

Objective To analyze the causes ofparotid gland injury after facial cosmetic surgery and put forward preventive measures.Methods From May 2013 to May 2019,11 patients with parotid gland injury caused by cosmetic surgery were retrospectively analyzed.There were 4 cases of rhytidectomy,4 cases of line carving,2 cases of fat grafting and 1 case of fat padremoval.The causes were analyzed and the preventive measures were proposed.Results Among these patients,7 cases were treated by conservative treatment and the masses disappeared within a week;4 cases were treated by operation and the wounds healed by first intention.After 3 months of follow-up,all patients retained the secretion function of parotid gland.The facial muscles and morphology recovered well.The patients were satisfied with the treatment efficacy and appearance.No recurrence was found in all patients.Conclusion The parotid gland injury after facial cosmetic surgery is mainly caused by unfamiliar with the local anatomy or rough operation.It is very important to strengthen the topographic anatomy to prevent the injury.