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目的总结腮腺手术中安全快捷地寻找面神经的方法。方法回顾分析1994年至2014年西安交通大学第一附属医院耳鼻喉科收治的810例良性腮腺肿瘤或囊肿的病例资料。结果术中465例采用总干法寻找面神经,其中11例未找到面神经总干而改用他法,3例术中损伤面神经总干;138例采用颧支法寻找面神经,均成功确认神经,无术中医源性损伤;74例采用下颌缘支法,均成功确认面神经,8例术中损伤;133例采用颊支法,均成功确认神经,5例术中损伤。结论腮腺手术中应以固定的解剖标志寻找面神经,首选总干法及颧支法,尽量避免下颌缘支法,但也要根据患者的具体情况采用合适的方法。
Objective To summarize the method of looking for facial nerve safely and quickly in parotid surgery. Methods The data of 810 cases of benign parotid tumors or cysts admitted to otolaryngology department of the First Affiliated Hospital of Xi’an Jiaotong University from 1994 to 2014 were retrospectively analyzed. Results 465 cases of facial nerve were treated by total dry method, of which 11 cases did not find the total dry facial nerve and used his method, 3 cases were injured facial nerve total dry; 138 cases using zygomatic branch method looking for facial nerve, nerve were successfully confirmed, no All the 74 cases were treated by mandibular marginal branch method, facial nerve was confirmed successfully, 8 cases were injured in operation, and 133 cases were treated by buccal branch method. Conclusion The parotid gland should be searched for the facial nerve with fixed anatomical landmarks. The total dry method and the zygomatic branch method are the best choice. The mandibular marginal branch method should be avoided as far as possible. However, appropriate methods should be used according to the patients’ specific conditions.