摘要：

目的：探讨经耳后发际切口行下颌下腺切除术的可行性、术后并发症及美容效果。方法：此次临床总结纳入的患者共计63例，均来自福建医科大学附属三明市第一医院口腔颌面外科，于2015年1月—2020年10月期间以单侧下颌下腺良性病变为诊断收入院，均行患侧下颌下腺切除术。在这些患者中，38例采用传统的颌下手术切口入路（颌下切口组），25例采用耳后发际切口入路（耳后发际切口组）。我们记录并比较2组的手术成功率、手术时间、神经损伤情况、术后面动、静脉出血及美容效果。结果：颌下切口组和耳后发际切口组所有患者的手术均顺利完成。在手术时间上，颌下切口组平均手术时间是（42.47±6.59） min，耳后发际切口组平均手术时间是（89.28±9.69） min，存在显著统计学差异（P<0.01）。颌下切口组无神经损伤表现及术后面动、静脉出血，耳后发际切口组只有术后耳垂暂时性麻木3例，无面神经下颌缘支、舌神经及舌下神经损伤表现及术后面动、静脉出血。术后美容效果方面，颌下切口组的美容效果评分平均为4.42分，而耳后发际切口组的评分平均为8.04分，有显著统计学差异（P<0.01）。结论：经耳后发际切口入路行下颌下腺切除术是一种安全可行的手术方法，而且相比传统的颌下切口入路，它的美容效果更好。

关键词: 下颌下腺, 颌下切口, 耳后发际切口

Abstract:

Objective: To evaluate the practicability, cosmetic results, and postoperative complications of submandibular gland excision via retroauricular hairline incision. Methods: A retrospective review of 63 patients who underwent excision of submandibular gland for unilateral benign neoplasm between January 2015 and October 2020, 38 patients were treated surgically via the conventional lateral transcervical approach (lateral transcervical approach group), and 25 patients were treated via retroauricular hairline incision (retroauricular hairline incision group). Between the 2 surgical procedures, success rate, surgery time, nerves injury, bleeding of facial artery and vein after surgery, and cosmetic outcome were compared. Results: All operations were finished successfully in two groups. A significant difference (P<0.01) in average surgery time (42.47±6.59) minutes in lateral transcervical approach group versus (89.28±9.69) minutes in retroauricular hairline incision group was found. There was no nerve injury and bleeding of facial artery and vein after surgery in two groups, but 3 patients who exhibited temporary damage to the earlobe numbness in retroauricular hairline incision group. There was a significant difference (P<0.01) in cosmetic outcome using a numerical scale (NS): 4.42 scores in lateral transcervical approach group versus 8.04 scores in retroauricular hairline incision group. Conclusion: Submandibular gland excision via retroauricular hairline incision is a viable and safe surgical approach, especially which has better cosmetic outcome.

Key words: submandibular gland, lateral transcervical approach, retroauricular hairline incision