The clinical efficacy analysis of the surgery of the posterior approach parotid gland region resection preserving retinal ganglion and parotid fascia
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摘要: 目的: 探讨采用保留耳大神经束与腮腺筋膜的后径路腮腺区域性切除术治疗腮腺良性肿瘤的临床疗效。方法: 将112例腮腺良性肿瘤患者随机分为对照组和治疗组,对照组行保留耳大神经与腮腺筋膜的前径路腮腺区域性切除术,治疗组行保留耳大神经束与腮腺筋膜的后径路腮腺区域性切除术。对两组患者的手术时间、术后局部麻木、Frey综合征、面瘫及术后复发情况等临床数据进行分析。结果: 两组术后复发、手术时间、面瘫发生率比较,差异均无统计学意义(均 P>0.05)。但术后6个月,对照组局部麻木率以及Frey综合征发生率更高,差异均有统计学意义(均P<0.05)。结论: 采用保留耳大神经束与腮腺筋膜的后径路腮腺区域性切除术能取得与传统手术一致的疗效,并发症少,术后瘢痕明显缩小且局部无凹陷畸形,更大程度上符合美容及功能性外科的要求。Abstract: Objective: To explore the clinical efficacy analysis the surgery of the posterior approach parotid gland resection preserving retinal ganglion and parotid fascia for the treatment of benign parotid tumour.Method: One hundred and twelve cases were randomly divided into control group and treatment group. The control group was treated by anterior approach parotid gland region resection preserving retinal ganglion and parotid fascia. The treatment group was treated by posterior approach parotid gland region resection preserving retinal ganglion and parotid fascia. The data of operation time, postoperative local numbness, Frey syndrome, facial paralysis and postoperative recurrence case were analyzed.Result: There was no postoperative recurrence case in both two groups, and there was no significant difference between two the groups in operation time and the percent of facial paralysis(all P>0.05).However, the percent of postoperative local numbness and Frey syndrome in control group were significantly higher than those in treatment group(all P<0.05).Conclusion: The treatment group had similar clinical efficacy with the traditional surgical operation. In addition, the operation of treatment group contributed to decreased postoperative complications.
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Key words:
- parotid neoplasms /
- parotid fascia /
- surgical procedures,operative
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[1] 张萌, 曹蜀炜, 刘建敏.腮腺手术中保留耳大神经的研究[J].临床耳鼻咽喉头颈外科杂志, 2015, 29(15):1354-1357.
[2] 杨建军, 徐宏, 邓婧,等. 改良腮腺筋膜瓣术式对预防Frey's综合征的作用[J].口腔颌面外科杂志, 2008,18(2):110-112.
[3] 温玉明,陈润良,王昌美,等.腮腺多形性腺瘤腺体切除范围的病理依据[J].华西口腔医学杂志,2003,21(5):359-360.
[4] 童永青,施更生, 戴杰,等. 腮腺良性肿瘤手术改良的临床研究[J].中华耳鼻咽喉头颈外科杂志, 2010, 45(2):151-153.
[5] 廖宗生. 腮腺良性肿瘤3种切除手术临床比较[J]. 口腔医学, 2009, 29(7): 391-392.
[6] LEVERSTEIN H,VAN DER WAL J E,TIWARI R M,et al.Surgical management of 246 previously untreated pleomorphic adenomas of the parotid gland[J].Br J Surg,1997,84:399-403.
[7] 阎威, 陈勇, 郭荣珍, 等. 应用面神经总干法行腮腺切除术的初步观察[J]. 河北医药, 2007, 29(10): 1082-1084.
[8] 区德明, 吴颖, 刘军, 等. 腮腺手术中顺行法与逆行法解剖对面神经功能影响的比较研究[J]. 口腔医学研究, 2015, 31(7): 712-714.
[9] 吴煜农,武和民,陶震江.程序化功能性腮腺切除术的初步探讨[J].口腔医学, 2005,25(6):348-350.
[10] VIEIRA M B,MAIA A F,RIBEIRO J C.Randornized prospective study of the validity of the great auricular nerve preservation in parotidectomy[J].Arch Otolaryngol Head Neck Surg,2002,128:1191-1195.
[11] RYAN W R, FEE W E Jr. Great auricular nerve morbidity after nerve sacrifice during parotidectomy[J].Arch Otolaryngol Head Neck Surg,2006,132:642-649.
[12] 俞辉明, 杨建荣, 房进. 腮腺手术中耳大神经的解剖与保留[J].口腔医学, 2011, 31(12): 740-742.
[13] 毛玉虎,王玫.保留耳大神经耳后支、耳垂支的腮腺肿瘤切除术39例报告[J].临床口腔医学杂志,2011,27(9):542-542.
[14] 李明月,张伟,刘宁,等.腮腺筋膜和耳大神经保留的改良方法[J].中国口腔颌面外科杂志,2009,7(4):366-369.
[15] 邱蔚六.口腔颌面外科理论与实践[M].北京:人民卫生出版社,1998:1123-1124.
[16] 曲延刚, 孙乐刚, 王丽芳, 等.腮腺手术植入涤纶薄片预防Frey综合征[J].实用口腔医学杂志, 2002, 18(2):175-177.
[17] SINHA U K, SAADAT D, DOHERTY C M, et al.Use of A lloDerm in plant to prevent frey syndrome after parotidectomy[J].Arch Facial Plast Surg, 2003, 5:109-112.
[18] ASAL K, KOYBASIOGLU A, INAL E, et al. Sternocleidomastoid muscle flap recon struction during parotidectomy to prevent Frey's syndrome and facial contour deformity[J].Ear Nose Throat J, 2005,84: 173-176.
[19] 许彪, 王卫红, 范红渠, 等.旋转腮腺筋膜瓣预防腮腺术后味觉出汗综合征[J]. 实用口腔医学杂志, 2005, 21(1):135-136.
[20] 王良忠, 曲延刚, 何开云. 保留腮腺筋膜预防叶觉出汗综合征的临床应用[J]. 口腔医学, 2009,29(7): 386-387.
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