论文部分内容阅读
目的总结改良耳后区入路下颌下腺摘除的手术方法及疗效。方法 2008年10月-2009年4月,收治8例下颌下腺良性病损患者。男女各4例;年龄32～54岁,平均38.5岁。其中下颌下腺导管结石伴下颌下腺炎5例,下颌下腺多形性腺瘤3例。病程2个月～5年。术中皮肤切口设计于耳后沟和发际线,保留颌外动脉、面前静脉,仅结扎其进入下颌下腺的分支血管,摘除下颌下腺及病变组织。结果手术均完整摘除下颌下腺及瘤体。手术时间45～75min,平均60min。术后切口均Ⅰ期愈合,无面神经下颌缘支或舌神经、舌下神经麻痹发生。1例因术中过度牵拉导致术后皮瓣血运不佳,未经特殊处理24h后恢复正常;其余皮瓣术后血运均正常。术后患者均获随访,随访时间1～6个月,平均3个月。切口瘢痕隐蔽,外观满意。结论改良耳后区入路下颌下腺摘除术具有操作简便、并发症少、术后外观较好等优点。
Objective To summarize the surgical methods and curative effects of submandibular gland removal in the posterior auricular area. Methods From October 2008 to April 2009, 8 patients with benign submandibular lesions were treated. 4 men and women in each case; aged 32 to 54 years, mean 38.5 years old. Including submandibular gland duct stones with submandibular gland inflammation in 5 cases, 3 cases of submandibular gland pleomorphic adenoma. Course of 2 months to 5 years. Intraoperative incision in the ear design of the posterior groove and hairline, retaining the external carotid artery, veins in front, only ligation of its submandibular gland into the branch of blood vessels, removal of the submandibular gland and diseased tissue. Results The surgery was complete removal of submandibular gland and tumor. Operative time 45 ~ 75min, an average of 60min. Postoperative incision healed by first intention, without facial mandibular marginal branch or lingual nerve, hypoglossal nerve paralysis occurred. 1 case due to excessive intraoperative pull led to poor blood supply flap after surgery, without special treatment after 24h returned to normal; the remaining flap blood flow were normal. Postoperative patients were followed up for 1 to 6 months, an average of 3 months. Hidden scar incision, the appearance of satisfaction. Conclusion The improved posterior submandibular approach has the advantages of simple operation, less complications and better postoperative appearance.