显微顺行腮腺切除术治疗不同类型腮腺肿瘤

Brihaspati Sigdel, T. Dubey
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摘要

简介:涎腺肿瘤约占头颈部肿瘤的5%。75%的此类肿瘤发生在腮腺。多形性腺瘤是涎腺良性肿瘤中最常见的类型。治疗不当易复发。腮腺肿瘤的手术包括腮腺摘除术、腮腺浅表切除术和腮腺全切除术。面神经干及其分支的识别和保存在腮腺手术中具有重要意义。显微外科技术的进步有助于更好地显示、识别和保存面神经。方法:这项前瞻性研究包括27名患者。所有病例均行术前超声检查和细针穿刺细胞学检查。在某些情况下需要进行计算机断层扫描/磁共振成像。标准显微外科技术在显微镜的帮助下进行顺行腮腺切除术。数据分析采用SPSS 26.0版软件进行。结果:患者年龄12~78岁。女性患者15例(55.6%)。4%)为男性。16个(59.3%)肿瘤位于右侧,而11个(40.7%)位于左侧。大多数肿瘤(n=18,66.7%)为多形性腺瘤。两名(7.4%)患者出现暂时性面瘫,随着时间的推移病情有所好转。两名(7.4%)患者出现血肿。随访中未发现弗雷综合征。结论:本研究显示应用显微外科技术进行腮腺切除术的发病率较低。面部神经未发现永久性损伤。
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Microscopic Antegrade Parotidectomy for Different Types of Parotid Tumor
Introduction: Salivary gland tumor accounts for about 5% of all the neoplasms of the head and neck. 75% of such tumors occur in the parotid glands. Pleomorphic adenoma is the most common type of benign salivary gland tumor. It tends to recur after inappropriate treatment. Surgery of parotid tumor includes enucleation, superficial parotidectomy and total parotidectomy. Identification and preservation of facial nerve trunk and its branches are very important in parotid surgery. Advancement of microsurgical technique has helped in better visualization, identification and preservation of the facial nerve. Methods: This prospective study included twenty-seven patients. Preoperative ultrasonography and fine needle aspiration cytology were done for all cases. Computed tomography/magnetic resonance imaging were performed in some cases when needed. Standard microsurgical technique with the help of microscope was performed for antegrade parotidectomy. Data analysis was done using SPSS version 26.0. Results: The patients' age ranged from 12 to 78 years. Fifteen (55.6%) patients were female and 12 (44. 4%) were males. Sixteen (59.3%) tumors were located on the right side whereas 11 (40.7%) were on the left side. Most of the tumors (n=18, 66.7%) were pleomorphic adenoma. Two (7.4%) of the patients had temporary facial paralysis which improved with time. Two (7.4%) patients had developed hematoma. Frey’s syndrome was not found in follow-up. Conclusion: This study showed low morbidity in parotidectomy using microsurgical techniques. No permanent injury to the facial nerve was found.
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