腮腺良性肿瘤切除附143例报告
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刘及 liuji9953@sina.com.

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Resection of parotid benign tumors(a report of 143 cases)
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    目的 分析腮腺良性肿瘤的外科治疗。方法 回顾分析1995年8月~2009年12月143例行腮腺良性肿瘤手术资料,其中腮腺浅叶肿瘤115例,深叶肿瘤28例。病理诊断Warthin瘤69例(占48.28%),混合瘤 63例(占44.06%)。其中有5例为双侧。行腮腺浅叶区域切除术73例,腮腺浅叶切除术42例,腮腺部分浅叶切除+深叶肿瘤切除 13 例,腮腺全切除12例,保留腮腺浅叶的深叶肿瘤切除3例。术中均解剖和保护面神经。保留腮腺导管89例。结果 术后随访6个月至2年。术中面神经损伤18例,术后半年内2例恢复不全。术后面神经不全麻痹者28例,均在2个月内完全恢复。涎瘘11例,半年内痊愈。Frey综合征6例。肿瘤复发2例。结论 腮腺良性肿瘤以腮腺浅叶区域切除为首选术式,腮腺浅叶切除为补充。深叶肿瘤可部分解剖面神经,酌情保留腮腺浅叶,使腮腺的功能和外观得到改善。术中勿苛求面神经支干的绝对干净。合理使用电刀可减少术中出血、面神经损伤及术后涎瘘。

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    Objective To analyze the surgical treatment of parotid benign tumors. Methods Clinical data of 143 patients with parotid gland benign tumors hospitalized from August 1995 to December 2009 was studied retrospectively. Of all the 143 cases, 28 tumors were located in deeplobe,115 in superficial lobe; 5 were bilateral. As for the pathological diagnosis, Warthin tumor was confirmed in 69 cases (48.28%) and mixed tumor in 63 cases (44.06%). As for the surgery, parotid partial superficial lobectomy was performed in 73 cases, parotid superficial lobectomy in 44 cases, parotid partial superficial lobectomy and deeplobe tumor resection in 13 cases, total parotidectomy in 12 cases and deeplobe tumor parotidectomy with preservation of the superficial lobe in 3 cases. During operation, the facial nerve was surgically anatomized and protected in all cases. The parotid duct was reserved in 89 cases. Results The postoperative followedup time ranged from six months to 2 years. Intraoperative facial nerve injury ocurred in 18 cases and got recovered within six months except incomplete recovery in 2. Incomplete paralysis of facial nerve in 28 cases which got complete restored with in 2 months. Salivary fistula in 11 cases recovered within six months. Frey syndrome ocurred in 6 cases. Tumor recurrence occurred in 2 cases. Conclusion For the benign tumor in the superficial lobe of parotid gland, regional surgical resection is preferred with superficial lobectomy as supplement. As for the deeplobe tumor, the facial nerve can be partially anatomized and the superficial lobe should be approciately retained to satisfy both patients and surgeons in the parotid function preservation and cosmetic appearance. Absolute clearance of the facial nerve branch is not excessively demanded. Rational use of electric knife can reduce blood loss, facial nerve injury, and postoperative salivary fistula formation.

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刘及 苏少武 谢飞虎 杨培新.腮腺良性肿瘤切除附143例报告[J].中国耳鼻咽喉颅底外科杂志,2011,17(3):185-188

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  • 在线发布日期: 2011-06-30
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