腮腺区域性切除术在腮腺良性肿瘤治疗中的临床价值

顾红波; 赵恩民; 李天成; 沈泓; 丛铁川; 秦永; 刘玉和; 肖水芳

doi:10.13201/j.issn.1001-1781.2018.09.007

腮腺区域性切除术在腮腺良性肿瘤治疗中的临床价值

- 北京大学第一医院耳鼻咽喉头颈外科(北京,100034)

详细信息

通讯作者: 赵恩民, E-mail:enmin_ent@sina.com

中图分类号: R762

收稿日期: 2017-12-08

The clinical assessment of regional resection in the benign tumor of parotid gland

- Department of Otolaryngology Head and Neck Surgery, the First Hospital of Peking University, Beijing, 100034, China

More Information

Corresponding author: ZHAO Enmin, E-mail: enmin_ent@sina.com

Received Date: 08 December 2017

摘要

摘要: 目的:[HT5"SS]探讨腮腺区域性切除术在腮腺良性肿瘤治疗中的临床价值。

关键词:
腮腺区域性切除 /

腮腺浅叶全切术 /

并发症 /

术区积液
Abstract: Objective: To evaluate the clinical assessment of regional resection and superficial lobe total resection in the treatment of benign tumors of the parotid gland.Method: One hundred and nighty-five patients operated in the First Hospital of Peking University from January 1998 to March 2017 with benign tumor of the parotid gland were retrospectively analyzed. There were 189 patients with single side tumor and 6 patients with bilateral sides, 157 cases underwent regional resection and the other 44 cases underwent superficial lobe total resection. All the results and complications were recorded and analyzed between the two groups.Result: There were total 195 patients with 201 cases. All the complications were as follows, 4 cases with recurrence, 44 cases with temporal facial paralysis, 13 cases with permanent facial paralysis, 80 cases with earlobe numbness, 49 cases with facial numbness, 44 cases with skin retraction, 26 cases with operated region effusion, 2 cases with sialosyrinx, 55 cases with Frey syndrome. There were no significant differences between the two groups in the incidences of recurrence, temporal facial paralysis, permanent facial paralysis, earlobe numbness, facial numbness, skin retraction. The incidence of Frey syndrome in the superficial lobe total resection group was significantly higher than the regional resection group(45.5%, 22.3%,P<0.05). The incidence of operated region effusion or sialosyrinx in the regional resection group was significantly higher than the superficial lobe total resection group (16.6%, 4.5%, P<0.05), further analysis showed that the operation method and the location of the tumor were the independent risk factors.Conclusion: Regional resection in the parotid gland tumor was less invasive, the incidences in the most complications were in consistent with superficial lobe total resection, and it was helpful in preventing the occurrence of Frey syndrome. Although regional resection conserved more parotid gland tissue so that the more conserved gland function and it also didn't increase the incidence of sialosyrinx, the operated region effusion was significantly increased. If the operated region effusion was not discovered and handled, there would be a risk of sialosyrinx.

Key words:
regional resection /

superficial lobe total resection /

complications /

operated region effusion

HTML全文

参考文献(18)

[1]
俞光岩, 马大权.腮腺肿瘤切除术的改进和发展[J].中华口腔医学杂志, 2007, 42 (1):6-9.

[2]
张小萌, 杨成章.腮腺浅叶良性肿瘤功能性手术的初步探讨[J].临床耳鼻咽喉头颈外科杂志, 2011, 25 (15):678-680.

[3]

BARZAN L, PIN M.Extra-capsular dissection in benign parotid tumors[J].Oral Oncol, 2012, 48:977-979.

[4]

PAPADOGEORGAKIS N.Partial superficial parotidectomy as the method of choice for treating pleomorphic adenomas of the parotid gland[J].Br J Oral Maxillofac Surg, 2011, 49:447-450.

[5]

KLINTWORTH N, ZENK J, KOCH M, et al.Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function[J].Laryngoscope, 2010, 120:484-490.

[6]

MOHAMMED F, ASARIA J, PAYNE R J, et al.Retrospective review of 242consecutive patients treated surgically for parotid gland tumours[J].J Otolaryngol Head Neck Surg, 2008, 37:340-346.

[7]
李超, 徐义全.腮腺多形性腺瘤安全手术切缘研究进展[J].中国肿瘤临床, 2011, 38 (4):238-240.

[8]

HENNEY S E, BROWN R, PHILLIPS D.Parotidectomy:the timing of post-operative complications[J].Eur Arch Otorhinolaryngol, 2010, 267:131-135.

[9]

POWELL M E, CLAIRMONT A A.Complications of parotidectomy[J].South Med J, 1983, 76:1109-1112.

[10]

ERKAN A N, YAVUZ H, OZER C, et al.Quality of life after surgery for benign disease of the parotid gland[J].J Laryngol Otol, 2008, 122:397-402.

[11]
杨茂进, 柴鉴深, 陈渝斌.保留腮腺咬肌筋膜的腮腺切除术[J].实用口腔医学杂志, 2005, 21 (2):234-236.

[12]
李超, 樊晋川, 李彬, 等.外科手段预防腮腺切除术后味觉出汗综合征等并发症的荟萃分析[J].中华耳鼻咽喉头颈外科杂志, 2011, 46 (7):580-585.

[13]
陈曦, 李进让, 孙建军.Frey综合征的临床诊治与进展[J].临床耳鼻咽喉头颈外科杂志, 2007, 21 (20):958-960.

[14]
李伟, 张现军.202例腮腺术后并发味觉出汗综合征发生率的临床分析[J].实用口腔医学杂志, 2016, 32 (1):131-132.

[15]
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.

[16]

LUO W, ZHENG X, CHEN L, et al.The use of human acellular dermal matrix in the prevention of infraauricular depressed deformities and Frey's syndrome following total parotidectomy[J].Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114:e9-13.

[17]

TUCKETT J, GLYNN R, SHEAHAN P.Impact of extent of parotid resection on postoperative wound complications:aprospective study[J].Head Neck, 2015, 37:64-68.

[18]

BLYTHE J N, KORAITIM M, ARCURI F, et al.Novel approach in the treatment of a persistent iatrogenic parotid fistula using AlloDerm?——an allogenic acellular dermal matrix[J].Br J Oral Maxillofac Surg, 2016, 54:109-110.

相关文章

施引文献

资源附件(0)

访问统计

计量

文章访问数: 317

PDF下载数: 249

施引文献: 0

出版历程

收稿日期: 2017-12-08

腮腺区域性切除术在腮腺良性肿瘤治疗中的临床价值

通讯作者: 赵恩民, E-mail:enmin_ent@sina.com

The clinical assessment of regional resection in the benign tumor of parotid gland

Corresponding author: ZHAO Enmin, E-mail: enmin_ent@sina.com

计量

目录

{{newsColumn.name}}

[1]	俞光岩, 马大权.腮腺肿瘤切除术的改进和发展[J].中华口腔医学杂志, 2007, 42 (1):6-9.
[2]	张小萌, 杨成章.腮腺浅叶良性肿瘤功能性手术的初步探讨[J].临床耳鼻咽喉头颈外科杂志, 2011, 25 (15):678-680.
[3]	BARZAN L, PIN M.Extra-capsular dissection in benign parotid tumors[J].Oral Oncol, 2012, 48:977-979.
[4]	PAPADOGEORGAKIS N.Partial superficial parotidectomy as the method of choice for treating pleomorphic adenomas of the parotid gland[J].Br J Oral Maxillofac Surg, 2011, 49:447-450.
[5]	KLINTWORTH N, ZENK J, KOCH M, et al.Postoperative complications after extracapsular dissection of benign parotid lesions with particular reference to facial nerve function[J].Laryngoscope, 2010, 120:484-490.
[6]	MOHAMMED F, ASARIA J, PAYNE R J, et al.Retrospective review of 242consecutive patients treated surgically for parotid gland tumours[J].J Otolaryngol Head Neck Surg, 2008, 37:340-346.
[7]	李超, 徐义全.腮腺多形性腺瘤安全手术切缘研究进展[J].中国肿瘤临床, 2011, 38 (4):238-240.
[8]	HENNEY S E, BROWN R, PHILLIPS D.Parotidectomy:the timing of post-operative complications[J].Eur Arch Otorhinolaryngol, 2010, 267:131-135.
[9]	POWELL M E, CLAIRMONT A A.Complications of parotidectomy[J].South Med J, 1983, 76:1109-1112.
[10]	ERKAN A N, YAVUZ H, OZER C, et al.Quality of life after surgery for benign disease of the parotid gland[J].J Laryngol Otol, 2008, 122:397-402.
[11]	杨茂进, 柴鉴深, 陈渝斌.保留腮腺咬肌筋膜的腮腺切除术[J].实用口腔医学杂志, 2005, 21 (2):234-236.
[12]	李超, 樊晋川, 李彬, 等.外科手段预防腮腺切除术后味觉出汗综合征等并发症的荟萃分析[J].中华耳鼻咽喉头颈外科杂志, 2011, 46 (7):580-585.
[13]	陈曦, 李进让, 孙建军.Frey综合征的临床诊治与进展[J].临床耳鼻咽喉头颈外科杂志, 2007, 21 (20):958-960.
[14]	李伟, 张现军.202例腮腺术后并发味觉出汗综合征发生率的临床分析[J].实用口腔医学杂志, 2016, 32 (1):131-132.
[15]	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.
[16]	LUO W, ZHENG X, CHEN L, et al.The use of human acellular dermal matrix in the prevention of infraauricular depressed deformities and Frey's syndrome following total parotidectomy[J].Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114:e9-13.
[17]	TUCKETT J, GLYNN R, SHEAHAN P.Impact of extent of parotid resection on postoperative wound complications:aprospective study[J].Head Neck, 2015, 37:64-68.
[18]	BLYTHE J N, KORAITIM M, ARCURI F, et al.Novel approach in the treatment of a persistent iatrogenic parotid fistula using AlloDerm?——an allogenic acellular dermal matrix[J].Br J Oral Maxillofac Surg, 2016, 54:109-110.