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目的评估胸锁乳突肌肌瓣联合脱细胞异体真皮基质在腮腺术后缺损区的临床应用效果。方法腮腺良性肿瘤患者218例分为四组:A组52例,腮腺缺损区用胸锁乳突肌肌瓣修复,并用脱细胞异体真皮覆盖创面;B组52例,只用脱细胞异体真皮基质覆盖创面;C组52例,仅用胸锁乳突肌肌瓣修复;D组62例,腮腺术后不修复,常规关闭伤口。术后随访6-24个月。结果 A、C组两侧面部对称,术侧无凹陷,术侧腮腺区丰满,与健侧基本对称;但A组的Frey综合征发生率为1.9%,低于C组的7.7%。B、D组术侧腮腺凹陷较明显,与健侧不对称;但B组的Frey综合征发生率为3.8%,低于D组的67.7%。A组预防Frey综合征的临床效果明显优于B、C、D组。结论自体胸锁乳突肌肌瓣联合应用脱细胞异体真皮基质修复腮腺术后缺损区,可以有效预防Frey综合征的发生,并能解决术侧凹陷畸形问题。
Objective To evaluate the clinical effect of sternocleidomastoid muscle flap combined with allogeneic dermal matrix in the parotid defect area. Methods 218 patients with benign parotid tumor were divided into four groups: group A, 52 cases, parotid gland defect area with sternocleidomastoid muscle flap repair, and acellular dermis covered with wound; group B, 52 cases, only acellular dermal matrix Covering the wound; C group 52 cases, only sternocleidomastoid muscle flap repair; D group 62 cases, parotid gland not repair, routine wound closure. The patients were followed up for 6-24 months. Results The facial parts of groups A and C were symmetrical, with no sag on the side of operation. The parotid gland region on the operation side was full and symmetrical with the contralateral side. However, the incidence of Frey syndrome in group A was 1.9%, which was lower than 7.7% in group C. The parotid sag in B and D groups was more obvious and contralateral to the contralateral side, but the incidence of Frey syndrome in group B was 3.8%, which was lower than that in group D (67.7%). A group of prevention of Frey syndrome clinical effect was significantly better than the B, C, D group. Conclusion Autologous sternocleidomastoid muscle flap combined with acellular dermal matrix repair parotid gland postoperative defect area, can effectively prevent the occurrence of Frey syndrome, and can solve the problem of lateral deformity.