CAJ | 학술논문

目的：比较改良型腮腺切除术与传统腮腺切除术在良性肿瘤切除中的效果，探讨采取改良切口，保留耳大神经、腮腺咬肌筋膜、腮腺导管和部分腮腺的改良腮腺切除术治疗腮腺肿瘤的临床效果和方法。方法：将我院2007～2012年收治的腮腺肿瘤患者80例分为2组，观察组采用美容切口，保留耳大神经、腮腺咬肌筋膜、腮腺导管和部分腮腺的改良腮腺切除术，对照组采用传统“ s”形手术切口。术后随访2～4年，临床检查暂时性面瘫、涎瘘和术后肿瘤复发情况。通过碘-淀粉试验观察术后味觉出汗综合征的发生率以及主观感受，并问卷调查耳垂区感觉及面部有无明显畸形等情况，对数据进行统计学分析。结果：术后暂时性面瘫、涎瘘和肿瘤复发率2组无统计学意义（P＞0．05）；味觉出汗综合征、耳垂区麻木发生率和患者面部明显畸形情况2组差异有统计学意义（ P＜0．05）。改良术式组明显优于传统术式组。结论：2种手术切口的术野暴露无差异，但改良腮腺手术切口隐蔽，不易损伤面神经周围支，无涎瘘及Frey综合征，较传统手术切口有明显优越性。
목적：비교개량형시선절제술여전통시선절제술재량성종류절제중적효과，탐토채취개량절구，보류이대신경、시선교기근막、시선도관화부분시선적개량시선절제술치료시선종류적림상효과화방법。방법：장아원2007～2012년수치적시선종류환자80례분위2조，관찰조채용미용절구，보류이대신경、시선교기근막、시선도관화부분시선적개량시선절제술，대조조채용전통“ s”형수술절구。술후수방2～4년，림상검사잠시성면탄、연루화술후종류복발정황。통과전-정분시험관찰술후미각출한종합정적발생솔이급주관감수，병문권조사이수구감각급면부유무명현기형등정황，대수거진행통계학분석。결과：술후잠시성면탄、연루화종류복발솔2조무통계학의의（P＞0．05）；미각출한종합정、이수구마목발생솔화환자면부명현기형정황2조차이유통계학의의（ P＜0．05）。개량술식조명현우우전통술식조。결론：2충수술절구적술야폭로무차이，단개량시선수술절구은폐，불역손상면신경주위지，무연루급Frey종합정，교전통수술절구유명현우월성。
Objective:A modified technique and its advantages in the treatment of parotidectomy comparing with traditional modalities . Methods:80 patients of pleomorphic adenoma of parotid selected from 2007 to 2012 were retrospectively reviewed , Patients were divided in to 2 groups:modified parotidectomy(MP) group and traditional parotidectomy ( TP) group( n=40 in each group).In the modified cases, great auricular nerve,parotid fascia,Stensen's duet ,and part of parotid substance were preserved .In TP group, parotidectomies were per-formed in a tradition alway.After 1-4 years follow -up, the incidence of provisional facial paralysis , salivary fistula,tumor recurrence, gustatory sweating syndrome and subjective reception use iodine -starch test were checked clinically .A structured questionnaire was con-structed, sensation of the ear lobe and facial contour were in cooperated into the questionnaire .The data analysis were performed using SPSS Windows version 13.0 and were assessed by t -tests and Chi square tests .Results:There was no difference between two groups in salivary fistula and tumor recurrence(P >0.05).In MP group,the incidence of provisional facial paralysis,gustatory sweating syndrome, sense of lobulus auriculae and prosopo -catagenesis was significantly lower than those in TP group ( p<0.05) .Conclusion:The modified in cision of parotidectomy greatly reduce the disadvantages of the traditional technique .It should be better than conventional technique .