腮腺良性肿瘤切除的改良术式
A Retrospective Study on the Complications after Modified Parotidectomy in Benign Tumors of Parotid Gland
作者：赵洪伟,李龙江,韩波,刘华,潘剑
Author：ZHAO Hong-wei,LILong-jiang,HANBo,LIUHua,PANJian
收稿日期：2005-02-25 年卷（期）页码：2005,23(01):53-
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：腮腺切除术,味觉出汗综合征,筋膜,并发症,
Key words：parotidectomy,gustatory sweating syndrome,fascia,complication,
基金项目：
中文摘要
目的 探讨保留腮腺嚼肌筋膜、耳大神经和胸锁乳突肌瓣整复的改良腮腺切除术对术后并发症的预防效果。方法 226例腮腺良性肿瘤患者随机分为4组。1组:94例患者采用保留腮腺嚼肌筋膜的腮腺切除术式;2组: 42例患者采用保留筋膜加胸锁乳突肌瓣整复的术式;3组:57例患者采用传统的皮下瓣(不保留腮腺嚼肌筋膜);4 组:33例患者采用不保留筋膜加胸锁乳突肌瓣整复的术式。患者术后随访2年,每2月1次。通过Minor试验和主观感受,观察术后患者味觉出汗综合征的发生,评价患者耳垂麻木和耳垂区软组织凹陷情况。结果 味觉出汗综合征的发生率1组(5·32%)或2组(4·76%)与3组(49·1%)或4组(51·5%)间在主观感受上存在统计学差异(P0·05)。微量淀粉碘试验检测示1组与3组或4组间有统计学差异(P0·05)。保留耳大神经后术区出现麻木症状较术前无明显改变。结论 腮腺切除术时保留腮腺嚼肌筋膜对预防味觉出汗综合征有显著效果。采用胸锁乳突肌瓣整复可以防止耳垂区的凹陷,取得较好的美学效果。保留耳大神经可预防术区感觉降低。
英文摘要
Objective A retrospective clinic study is presented of surgical patients undergoing a modified parotidectomy with conserving the sub-superficial musculoaponeurotic system (sub-SMAS) and great auricular nerve and reconstructing by the sterno- cleidomastoid flap(SF). The incidence of clinical complications was observed after the parotidectomy.Methods 226 patients were divided randomly into fourgroups. Group 1 (94 cases) were operated bythe conservingthe sub-SMAS. Group 2 were operat- ed by the sub-SMAS and constructed by SF. Group 3 (57 cases) were treated by the subcutaneous flap (sub-CF). Group 4 (33 cases) were received by sub-CF and SF. The surgical technique was described and the incidence of clinical Frey′s syndrome was evaluated by minor test(starch-iodine test)and observed gustatory sweating syndrome. The feeling and concave of the region of au- ricular lobule were followed up.Results The incidence of Frey′s syndrome in group 1 (5·32%) or group 2 (4·76%) was sig- nificantly lower than that of group 3 (49·1%) or group 4 (51·5%) through by subjective observation and minor test(P
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