耳后隐蔽切口逆向解剖面神经在腮腺部分切除术中的临床应用
[摘要]目的：探讨耳后隐蔽切口沿下颌缘支逆向解剖面神经在腮腺部分切除术中的临床疗效。方法：选取2015年1月-2018年1月收治的62例腮腺肿瘤患者进行观察，随机分为观察组和对照组，对照组采用传统“S”形手术方法，观察组采用耳后隐蔽切口沿下颌缘支逆向解剖面神经方法，术后对患者进行随访，比较两组术后面神经功能、手术并发症、切口瘢痕评分及患者对术后切口美容效果的满意度。结果：术后随访6～12个月，两组面神经功能分级情况比较，观察组面神经功能分级以Ⅰ～Ⅲ级为主，明显优于对照组，差异有统计学意义(P<0.05)。观察组涎瘘、Frey综合征、耳垂麻木以及口干等并发症发生率低于对照组，差异有统计学意义(P<0.05)。术后6个月和术后12個月观察组评分均明显低于对照组，差异有统计学意义(P<0.05)。术后12个月，观察组患者满意度大于对照组，差异有统计学意义(P<0.05)。结论：耳后隐蔽切口沿下颌缘支逆向解剖面神经的腮腺部分切除术面神经功能保护较好，并发症少，切口美容效果好，值得临床推广应用。
[关键词]腮腺肿瘤;耳后隐蔽切口;面神经下颌缘支;腮腺部分切除术
[中图分类号]R782 [文献标志码]A [文章编号]1008-6455(2020)02-0037-04
Abstract： Objective To investigate the clinical effect of the reverse anatomical facial nerve with the concealed incision behind the ear along the mandibular branch in partial parotidectomy. Methods Sixty-two patients with parotid gland tumors admitted between January 2015 and January 2018 were enrolled and randomly divided into the observation group and the control group. The control group was treated with traditional “S” surgery. The observation group was treated with the reverse anatomical facial nerve with the concealed incision behind the ear along the mandibular branch. The patients were followed up after operation. The facial nerve function， surgical complications， incision scar score and the patients' satisfaction with the cosmetic effect of the incision were compared. Results After 6-12 months follow-up， the facial nerve function grades of the two groups were compared. The facial nerve function grades of the observation group were mainly grade I-III， which was significantly better than that of the control group， the differences were statistically significant(P<0.05). The incidence of salivary fistula， Frey syndrome， earlobe numbness and dry mouth in the observation group were lower than that in the control group(P<0.05). The score of the observation group was significantly lower than that of the control group at 6 months and 12 months after operation(P<0.05). 12 months after operation， the patients' satisfaction in the observation group was higher than that in the control group(P<0.05). Conclusion The reverse anatomical facial nerve with the concealed incision behind the ear along the mandibular branch in partial parotidectomy has better facial nerve function protection， less complications， and good incision cosmetic effect， and it is worthy of clinical application.
Key words： parotid gland tumors; retroauricular concealed incision; marginal mandibular branch of facial nerve; partial parotidectomy, http://www.100md.com(曹佳 陆子龙 许争 夏立明)
[关键词]腮腺肿瘤;耳后隐蔽切口;面神经下颌缘支;腮腺部分切除术
[中图分类号]R782 [文献标志码]A [文章编号]1008-6455(2020)02-0037-04
Abstract： Objective To investigate the clinical effect of the reverse anatomical facial nerve with the concealed incision behind the ear along the mandibular branch in partial parotidectomy. Methods Sixty-two patients with parotid gland tumors admitted between January 2015 and January 2018 were enrolled and randomly divided into the observation group and the control group. The control group was treated with traditional “S” surgery. The observation group was treated with the reverse anatomical facial nerve with the concealed incision behind the ear along the mandibular branch. The patients were followed up after operation. The facial nerve function， surgical complications， incision scar score and the patients' satisfaction with the cosmetic effect of the incision were compared. Results After 6-12 months follow-up， the facial nerve function grades of the two groups were compared. The facial nerve function grades of the observation group were mainly grade I-III， which was significantly better than that of the control group， the differences were statistically significant(P<0.05). The incidence of salivary fistula， Frey syndrome， earlobe numbness and dry mouth in the observation group were lower than that in the control group(P<0.05). The score of the observation group was significantly lower than that of the control group at 6 months and 12 months after operation(P<0.05). 12 months after operation， the patients' satisfaction in the observation group was higher than that in the control group(P<0.05). Conclusion The reverse anatomical facial nerve with the concealed incision behind the ear along the mandibular branch in partial parotidectomy has better facial nerve function protection， less complications， and good incision cosmetic effect， and it is worthy of clinical application.
Key words： parotid gland tumors; retroauricular concealed incision; marginal mandibular branch of facial nerve; partial parotidectomy, http://www.100md.com(曹佳 陆子龙 许争 夏立明)