The application of modified cosmetic incision and skin adhesive in parotid benign tumor functional surgery
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摘要: 目的:探讨改良美容切口及氰基丙烯酸辛基酯皮肤粘合剂(Dermabond)在腮腺良性肿瘤功能性外科中的临床应用价值及相关技术。方法:将42例腮腺良性肿瘤患者随机分为A、B两组,A组应用改良美容切口作为入路,术后采用6-0可吸收薇乔缝线真皮内缝合外用Dermabond粘合进行切口关闭;B组采用传统S形切口,术后采用4-0普里灵(Prolene)缝线进行皮肤单层连续缝合。比较两组的手术时间、术后引流量、面神经功能、涎瘘、Frey综合征、术区麻木程度、瘢痕和美观满意度等指标。采用SPSS20.0软件包对数据进行统计学分析。结果:手术时间、面神经功能、Frey综合征、涎瘘、面部畸形、耳垂麻木、永久性面瘫及肿瘤复发在两组间的差异无统计学意义(P>0.05);而术后引流量、术区麻木程度、面部美观满意度及术后瘢痕,A、B两组差异有统计学意义(P<0.05)。结论:应用改良美容切口及Dermabond安全可行,并发症低于传统术式,瘢痕微小且隐蔽,患者满意度高,达到了微创治疗的效果。Abstract: Objective: To investigate the clinical application value and related technology of modified cosmetic incision and cyanoacrylate octyl ester skin adhesive (Dermabond) in functional surgery of parotid benign tumor. Method: Forty-two cases of clinical cases were collected and randomly divided into groups of A and B. Group A used the approach of modified cosmetic incision,intradermal suture with 6-0 absorbable Vicryl stitches and gluing the skin with Dermabond. Group B used the approach of traditional S shaped incision and continuous suture of skin with 4-0 Prolene stitches.The operative time, postoperative drainage volume, facial nerve function, salivary leakage, Frey syndrome, postoperative numbness, scar and aesthetic satisfaction were compared between the two groups.Result: The operation time, facial nerve function,Frey syndrome, salivary fistula, facial deformity and tumor recurrence in the two groups had no significant difference (P>0.05); but for postoperative drainage, postoperative numbness, facial appearance satisfaction, scar assessment, Group A was lower than Group B and there was statistical significance difference (P<0.05).Conclusion: The application of modified cosmetic incision and Dermond is safe and feasible. Its complication is lower than the traditional operation. The scar is smaller and more hidden, and the patient's satisfaction is higher. It doesn't affect the daily social interaction of patients, and achieves the effect of minimally invasive treatment.
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[1] 张震康,俞光岩. 口腔颌面外科学[M]. 2版. 北京:北京大学医学出版社,2013:328-329.
[2] 俞光岩,马大权. 北京大学口腔医院唾液腺肿瘤研究50年回顾[J]. 北京大学学报(医学版)医学版,2015,47(1):1-7.
[3] LEE S, SEOL H J, PARK K, et al. Functional Outcome of the Facial Nerve After Surgery for Vestibular Schwannoma:Prediction of Acceptable Long-Term Facial Nerve Function Based on Immediate Postoperative Facial Palsy[J]. World Neurosurg,2016,89:215-222.
[4] SEO S R, KANG N O, YOON M S, et al. Measurements of scar properties by SkinFibroMeter®,SkinGlossMeter®,and Mexameter® and comparison with Vancouver Scar Scale[J]. Skin Res Technol,2017,23:295-302.
[5] PAYNE S R,FORD T F,WICKHAM J E.Endoscopic management of upper urinary tract stones[J].Br J Surg,1985,72:822-824.
[6] 刘洪臣. 微创医学与口腔微创医学[J]. 口腔颌面修复学杂志,2017,18(2):65-68.
[7] TERRIS D J, TUFFO K M, FEE W E. Modified facelift incision for parotidectomy[J]. J Laryngol Otol,1994,108:574-578.
[8] 徐志坚,陈良嗣,詹建东,等. 改良面部除皱切口与改良Blair切口在腮腺浅叶肿瘤切除术中的对照研究[J]. 临床耳鼻咽喉头颈外科杂志,2017,31(21):1684-1687.
[9] 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.
[10] 吕继连,张瑞,张帅.腮腺良性肿瘤2种解剖面神经术式术后面神经损伤的临床研究[J]. 临床耳鼻咽喉头颈外科杂志,2017,31(6):456-460.
[11] GRAMMATICA A, PEROTTI P, MANCINI F, et al. Great auricular nerve preservation in parotid gland surgery:Long-term outcomes[J]. Laryngoscope,2015,125:1107-1112.
[12] GLENNIE R A, KORCZAK A, NAUDIE D D, et al. MONOCRYL and DERMABOND vs Staples in Total Hip Arthroplasty Performed Through a Lateral Skin Incision:A Randomized Controlled Trial Using a Patient-Centered Assessment Tool[J].J Arthroplasty,2017,32:2431-2435.
[13] DOWLING S T, LIN B W. Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries[J]. Adv Skin Wound Care,2017,30:460-463.
[14] 杨洋,叶晓健,杨成伟,等.腰椎间盘纤维环切口不同修复方法的生物力学研究[J].中国脊柱脊髓杂志,2014,24(7):626-629.
[15] YAGNATOVSKY M, PHAM H, ROKITO A, et al. Type Ⅳ hypersensitivity reactions following Dermabond adhesive utilization in knee surgery:A Report of Three Cases[J]. Phys Sportsmed,2017, 45:195-198.
[16] ARK M, COSMAN P H, BOUGHTON P, et al. Review:Photochemical Tissue Bonding (PTB) methods for Sutureless Tissue Adhesion[J]. Int J Adhesion Adhesives,2016,71:87-98.
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