The clinical application of modified rhytidectomy incision in superficial parotid tumor surgery
-
摘要: 目的:评价改良面部除皱切口在腮腺浅叶肿瘤切除术中的应用价值。方法:采用改良面部除皱切口,实施面神经解剖加腮腺浅叶部分(或腮腺浅叶)切除术35例,观察该入路的术野暴露、美观程度及并发症发生率。结果:所有病例术野暴露良好,均完整切除肿瘤。术后面神经下颌缘支暂时性麻痹5例(14.3%),暂时性耳垂麻木6例(17.1%),均在1~3个月后缓解;无涎瘘;术后3个月患者平均客观美容满意度评分8.5分,所有患者对术后美容效果满意。随访24~60个月(中位随访期:48个月),未见肿瘤复发。结论:改良面部除皱切口应用于腮腺浅叶肿瘤切除,术野暴露良好、切口相对隐蔽、术后美容效果良好、无明显并发症,值得临床推广应用。Abstract: Objective: To evaluate the modified rhytidectomy incision in superficial parotidectomy. Method: Thirty-five patients with superficial parotid tumor were included in this study. A modified rhytidectomy incision often used in facial plastic surgery was used for superficial parotidectomy and subtotal superficial parotidectomy with preservation of facial nerve and great auricular nerve. The follow-up study included the exposed region,the cosmetic effect of this approach and the rate of complication. Result: All patients healed without salivary fistula, and were satisfied with this modified approach. Temporary paralysis of the marginal mandibular branch of facial nerve were found in five patients, and six patients felt insensible around earlobe after operation. They all recovered in 1 to 3 months after surgery., no recurrence was happened during follow-up in 36 to 60 months(median follow-up period was 48 months). Conclusion: The modified rhytidectomy incision provided good exposure,had less complication and better cosmetic outcome.
-
Key words:
- parotidectomy /
- modified rhytidectomy incision /
- modified Blair incision /
- facial nerve /
- cosmetic
-
[1] 詹建东, 陈良嗣, 张思毅, 等. 腮腺浅叶下极良性肿瘤微创切除术[J].广东医学,2011, 32(7):109-111.
[2] 周梁, 李采, 张孝通. 腮腺多形性腺瘤手术方式的选择[J].中华耳鼻咽喉头颈外科杂志,2005,40(12):922-924.
[3] 陈良嗣, 张思毅, 黄晓明, 等. 内镜辅助耳后发际入路上颈良性肿物切除术[J].中国内镜杂志, 2011, 17(4):365-369.
[4] APPIANI E. Handling of a parotidectomy and muscular graft[J].Prensa Med Argent, 1967,54:1242-1243.
[5] 郭传瑸, 俞光岩, 毛驰, 等. 腮腺肿瘤手术入路的选择[J].中华耳鼻咽喉头颈外科杂志,2005,40(5):396-398.
[6] TERRIS D J, TUFFO K M, FEE W E. Modified facelift incision for parotidectomy[J].J Laryngol Otol, 1994,108:574-578.
[7] LEE S Y, KOH Y W, KIM B G, et al. The extended Indication of parotidectomy using the modified facelift incision in benign lesions:retrospective analysis of a single institution[J].World J Surg, 2011,35:2228-2237.
[8] GRACIANO A J, CHONE C T, FISCHER C A, et al. Cervicomastoidfacial versus modified rhytidectomy incision for benign parotid tumors[J].Braz J Otorhinolaryngol. 2013,79:168-172.
[9] GROVER N, D'SOUZA A. Facelift approach for parotidectomy:an evolving aesthetic technique[J].Otolaryngol Head Neck Surg,2013, 148:548-556.
[10] LOHUIS P J, TAN M L, BONTE K, et al. Superficial parotidectomy via facelift incision[J].Ann Otol Rhinol Laryngol, 2009,118:276-280.
[11] UPILE T, JERJES W K, NOURAEI S A,et al. Further anatomical approaches to parotid surgery[J].Eur Arch Otorhinolaryngol, 2010,267:793-800.
[12] AMIN A, MOSTAFA A, RIFAAT M, et al. Parotidectomy for benign parotid tumors:an aesthetic approach[J]. J Egypt Natl Canc Inst, 2011,23:67-72.
[13] 屠规益, 唐平章, 徐震纲. 颈部淋巴结转移癌临床——经典与现代理念[J].北京:人民卫生出版社, 2010:189-189.
[14] WASSON J, KARIM H, YEO J, et al. Cervicomastoidfacial versus modified facelift incision for parotid surgery:a patient feedback comparison[J]. Ann R Coll Surg Engl, 2010,92:40-43.
计量
- 文章访问数: 50
- PDF下载数: 50
- 施引文献: 0