腮腺肿瘤手术57例临床体会

目的探讨腮腺肿瘤手术方式、手术范围与治疗效果的关系。方法对1997～2003年间面神经解剖行腮腺肿瘤切除术57例(腮腺浅叶切除术51例，全腮腺切除术6例，1例行功能性颈淋巴结清扫术，术后加放疗4例)的临床随访资料进行分析。结果腮腺浅叶切除术51例中，并发暂时性面瘫5例，持续性面瘫1例，全腮腺切除6例中，并发暂时性面瘫2例，持续性面瘫2例，无腮腺瘘及Frey综合征，随访6月～7年无复发。结论腮腺良性肿瘤应施行解剖面神经的腮腺浅叶及肿瘤切除，恶性肿瘤在面神经尚未累及时行保留面神经的腮腺广泛切除，术后辅以放疗，可以减少肿瘤复发和面瘫等并发症的发生。

Clinical experience in the surgical treatment for parotid tumors-A report of 57 cases

Objective To discuss the clinical experience in the surgical treatment for parotid tumors, with special focus on the discussion of association of surgical procedures and extent with therapeutic effects on this kind of lesions. Methods A retrospective study was carried out among 57 cases undergone surgical treatment for parotid tumors in our clinic from 1997 to 2003. Among these cases,51 were undergone superficial parotidectomy, 6 were given total parotidectomy, 1 supplemented with functional neck dissection and 4 combined with postoperative radiotherapy. Moreover, facial nerve dissection was performed during the operation among 54 cases. Results Among the 51 cases undergone superficial parotidectomy ,5 were complicated with sustained prosopoplegia. In contrast ,temporary facial nerve palsy was seen in 2 and sustained such a condition was occurred in another 2 among the cases undergone total parotidectomy. None was seen with the lesion reoccurred during the following up period lasted for 6 months to 7 years and no one was met with Frey's syndrome or parotid fistula in this group of cases. Conclusions Superficial parotidectomy combined with facial nerve dissection should be performed for cases with benign parotid tumor. However ,parotidectomy in a larger extent should be carried out for cases with malignant parotid neoplasm,with facial nerve reserved when this nerve is not involved yet, supplemented with postoperative radiotherapy to reduce the risk of complications occurred in facial nerve and the risk of tumor reoccurring.