中国实用口腔科杂志

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腮腺浅叶多形性腺瘤区域性切除治疗28例临床分析

文世生郭雯瑾
  

  1. 甘肃嘉峪关市第一人民医院口腔科
  • 收稿日期:2009-08-17 修回日期:2009-09-20 出版日期:2009-11-15 发布日期:2010-04-02

  • Received:2009-08-17 Revised:2009-09-20 Online:2009-11-15 Published:2010-04-02

摘要:

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。

关键词: 腮腺浅叶多形性腺瘤, 腮腺区域性切除术, 并发症

Abstract:

Objective To investigate the feasibility of resection of parotid glands in treating the benign parotid tumor of parotid gland pleomorphic adenoma. Methods A total of 28 patients accepted the treatment of resection of parotid glands with retaining parotid main duct,who had had the case of benign parotid tumor,and the data analyzed. Results There was no recurrence for 3-5 years after surgical treatment;all achieved success in treatment. Complications:among 28 patients,one patient got temporary paralysis of zygomatic branch of facial nerve;Two patients got temporary paralysis of the facial nerve buccal branch,but both recovered within 1-3 months;four patients got local parotid gland fluid;one patient got frey syndrome. Conclusion The resection of parotid glands of the superficial lobe in parotid gland pleomorphic adenoma is a appropriate surgical method to treat the superficial lobe in parotid gland pleomorphic adenoma. It can maintain the symmetry of facial shape and avoid the occurrence of other complications including deformity.

Key words: the superficial lobe of parotid gland pleomorphic adenoma, resection of parotid glands, complication