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患者孟××,女,45岁。住院号85—2248。15年前左腮腺区有一肿块,疑为“腮腺混合瘤”,在当地医院手术,未作病检,术后一直很好,5个月前发现原手术区内有一肿块,慢慢增大,无任何不适,近半个月自觉低热,局部稍疼痛而来我院就诊。全身检查无特殊,摄左下颌升枝 X 线片无异常。专科检查:左耳垂下前方有5×4×4cm肿块,质中,呈结节状,活动度差,无压痛,表面皮肤颜色正常,酸刺激左腮腺分泌功能差,左耳前可见“S”形手术疤痕。初步诊断:左腮腺混合瘤(术后复发)。入院后在局麻下行保留面神经的腮腺肿瘤切除术,切口按原“S”形切口进行,术中见腮腺组织较少,肿瘤上方有包膜,深面与嚼肌下颌升枝粘连.剥
The patient Meng × ×, female, 45 years old. Hospital No. 85-2248. There was a lump in the left parotid gland 15 years ago. The suspected parotid gland mixed tumor was operated on in a local hospital without a medical examination. The operation was always good. A mass was found in the original surgical area 5 months ago. , slowly increased, without any discomfort, consciously low fever in the past half a month, local pain slightly came to our hospital. There was no special examination of the whole body. There was no abnormality in the X-ray film of the left lower jaw. Specialist examination: There is a 5×4×4cm mass under the left earlobe. The mass is nodular, with poor activity, no tenderness, normal skin color, and poor stimulation of the left parotid gland by acid stimulation. “S” is visible in the left ear. Surgical scars. Initial diagnosis: mixed tumor of left parotid gland (recurrence after operation). After admission, parotid tumors were preserved in the facial nerve under the local anesthesia. The incision was performed according to the original “S” incision. There were fewer parotid glands in the surgery. There was an envelope on top of the tumor, and the deep surface adhered to the chewing muscle and the lower jaw.