摘要： 目的： 总结应用倒S形切口、保留耳大神经及腮腺咬肌筋膜重建的改良腮腺良性肿瘤切除术式的临床治疗效果。方法： 40例术中明确诊断为腮腺良性肿瘤的患者随机分成2组，A组（18例）采用改良术式（倒S切口、保留耳大神经、重建腮腺咬肌筋膜），B组（22例）采用传统腮腺浅叶或全叶切除术式，术后评价临床治疗效果。结果： 全部手术均顺利完成，术后均随访12～24月。A组患者均术后面部瘢痕隐蔽，面部无凹陷，未出现暂时性面瘫，有短期耳垂麻木感2例（11.1%）、味觉出汗综合征2例（11.1%）。而B组有耳垂麻木7例（31.8%），暂时性面瘫12例（54.5%），味觉出汗综合征14例（63.6％）。结论： 改良腮腺良性肿瘤切除术较传统术式操作简单，容易掌握，能够克服传统术式易导致面神经损伤以及面部瘢痕明显的问题，能较好地预防味觉出汗综合征。

关键词: 腮腺切除术, 改良切口, 胸锁乳突肌瓣, 腮腺咬肌筋膜重建

Abstract:  Objective: To review the advantages of a  modified technique in the surgical treatment of superficial parotid gland benign tumors. Methods: 40 patients were randomly divided into two groups and retrospectively reviewed. In group A (n = 18), patients were treated by the modified operation including aesthetic incision, preserving great auricular nerve, partial resection of parotid and reconstructed by parotidomasseteric fascial flap. In group B (n=22), patients were treated by a conventional technique. All patients were assessed with their functions and complications  postoperatively. Results: All patients were followed up from 12 to 24 months. In group A, none was found of temporary facial paralysis, visible scar and retromandibular depression, 2 cases showed temporary ear lobe numbness, and 2 cases suffered from Frey’s syndrome. In group B, 7 cases showed ear lobe numbness, 12 cases suffered from facial paralysis, and 14 cases suffered from Frey’s syndrome. Conclusion: The procedure of the modified parotidectomy is simple and useful in avoiding injury of facial nerve and great auricular nerve, avoiding facial deformity and preventing Frey’s syndrome postoperatively. The incision scar is concealed with satisfied aesthetic effect.

Key words: parotidectomy, modified incision, sternocleidomastoideus flap, reconstruction of parotidomasseteric fascial flap

中图分类号: 

• R739.87