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目的探讨采用肿瘤及其就位腺体区域性切除的方法治疗腮腺浅叶良性肿瘤的可行性。方法对2004—2006年甘肃嘉峪关市第一人民医院口腔科收治的28例腮腺浅叶良性肿瘤患者,采用肿瘤及其就位腺体区域性切除+局部面神经解剖并且保留腮腺主导管的术式治疗,术后随访观察疗效。结果28例腮腺浅叶良性肿瘤患者治疗后,经过3～5年的随访无一例复发,均达到治愈目的。术后并发症:出现面神经颧支暂时性瘫痪1例,颊支暂时性瘫痪2例,经应用营养神经药物治疗,1～3个月后均恢复正常;发生腮腺局部积液4例,经穿刺抽液换药,加压包扎后均得到痊愈,无一例涎瘘发生;出现味觉出汗综合征1例,但范围较小;愈后检查患者,手术侧凹陷不明显,面部左右基本对称,腮腺检查分泌功能基本正常。结论肿瘤及其就位腺体区域性切除的方法是治疗腮腺浅叶多形性腺瘤或其他良性肿瘤合适的手术方式。与标准的保留面神经的肿瘤及腮腺浅叶或全腮腺切除术相比,能减少面神经损伤、涎瘘、味觉出汗综合征的发生,更重要的是能够保持面部形态的对称性,避免畸形等并发症的发生。
Objective To explore the feasibility of using tumor and its regional excision in situ glands to treat benign tumors of the parotid gland. Methods Twenty-eight patients with benign parotid gland tumors treated in Department of Stomatology, First People’s Hospital of Jiayuguan City, Gansu Province from 2004 to 2006 were treated with regional excision of the tumor and its gland in situ with local facial nerve anatomy and surgical treatment of the parotid main duct Follow-up observation of the curative effect. Results 28 cases of benign tumor of parotid glandular tumors after treatment, after 3 to 5 years of follow-up no case of recurrence, are to achieve the purpose of cure. Postoperative complications: facial nerve zygomatic temporary paralysis in 1 case, buccal branch temporary paralysis in 2 cases, after application of neurotrauma medication, 1 to 3 months after the return to normal; parotid gland partial effusion occurred in 4 cases, puncture There was no case of salivary fistula. One case of taste sweating syndrome appeared, but the range was small. After the operation, the patients had no significant depression on the operation side, the left and right sides of the face were basically symmetrical, the parotid gland Check the secretion function is normal. Conclusions The method of regional excision of the tumor and its in situ gland is a suitable surgical modality for the treatment of parotid glandular pleomorphic adenoma or other benign tumors. It can reduce facial nerve injury, salivary fistula and taste sweating syndrome more than the standard tumor that preserves the facial nerve and the parotid gland or total parotidectomy. More importantly, it can maintain the symmetry of the facial shape and avoid deformity, etc. Complications occur.