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目的:探讨内镜辅助下进行腮腺手术切除的临床效果。方法:对2004年10月-2006年9月就诊的15例腮腺肿物住院患者采用无注气内镜辅助下腮腺切除手术。通过耳垂后下方皮纹小切口,在颈深筋膜浅层,采用高频超声刀切割分离,远端借助监视器锐性分离,暴露腮腺浅叶。内镜下解剖面神经主干及分支,超声刀切除腮腺,伤口负压引流。结果:耳垂后下方切口长4.0～5.4cm,平均4.8cm。手术麻醉时间平均115min。腮腺浅叶切除3例,部分腮腺浅叶切除11例。术后病理诊断为多形性腺瘤8例,Warthin瘤4例,淋巴上皮病1例,淋巴结反应性增生1例。随诊6～31个月,平均14个月。面神经轻度麻痹5例,均在6个月内恢复正常。结论:内镜辅助下腮腺切除手术适用于腮腺浅叶良性肿瘤的切除,切口小且隐蔽,手术创伤小,有利于患者的恢复。
Objective: To investigate the clinical effect of parotidectomy assisted by endoscopy. Methods: Fifteen patients with parotid gland masses attending from October 2004 to September 2006 underwent non-endoscopic assisted parotid gland resection. After the earlobe through the dermatoglyphic incision, the deep fascia in the neck, the use of high-frequency ultrasonic knife cutting and separation, the distal sharp separation by monitor, exposed parotid shin. Endoscopic anatomical nerve trunk and branches, parotid gastrectomy knife, wound drainage. Results: The posterior inferior ear incision 4.0 ~ 5.4cm, an average of 4.8cm. The average time of surgical anesthesia is 115 minutes. Parotid shunt in 3 cases, partial parotid shunt in 11 cases. Postoperative pathological diagnosis of pleomorphic adenoma in 8 cases, Warthin tumor in 4 cases, 1 case of lymphatic epithelial disease, lymph node hyperplasia in 1 case. Follow-up 6 to 31 months, an average of 14 months. Facial nerve paralysis in 5 cases, were returned to normal within 6 months. Conclusion: Endoscopic assisted parotidectomy is suitable for resection of benign tumors of the parotid gland. The incision is small and hidden, and the surgical trauma is small, which is in favor of the patient’s recovery.