腮腺肿瘤155例诊治体会

摘要

Objective :To investigate the feathers and diagnosis of parotid gland tumor and prevention of its complications.Methods: Between 1998 and 2008, we treated 155 patients with parotid gland neoplasm and the clinical data in those cases were reviewed regarding the preoperative diagnostic examination, therapies and incidence of complications.Results:93％ of the cases were confirmed by CT.Eleven patients received partial parotidectmy and had no accident of facial paralysis.Yet, temporary facial paralysis was found in l0 cases undergone superficial parotidectomy and 15 by total parotidectomy.Five cases had permanent facial paralysis.Salivary fistula after surgery was seen in one case and relapse, in 3.Twelve cases were complicated with Frey syndrome, but numbness of auricular lobule was free in the 56 cases with auricular nerve retained.Conclusion:CT can be preferred as the preoperative diagnostic examination for its accuracy.Surgical zone removal of the primary tumor and management of the facial nerve and cervical nodes should be decided by the findings of rapid frozen section.Postoperative pathological examination may determine whether radiotherapy is necessary or not.Additionally,conventional pressure dressing may prevent salivary fistula after the surgery, and saving of the auricular nerve is essential to keep the ear lobe from numbness.%目的:研究腮腺肿瘤的特点、诊断和治疗方法及手术并发症的防治.方法:对我科1998～2008年所有手术治疗腮腺肿瘤的155例术前辅助检查、各种治疗方法及各种并发症进行分析.结果:CT诊断准确性最高(93%).部分腮腺切除术11例,术后未发现面瘫症状;腮腺浅叶切除术术后出现暂时性面瘫10例;全腮腺切除术术后出现暂时性面瘫15例,永久性面瘫5例;术后涎瘘1例,肿瘤术后复发3例;味觉出汗综合征12例.保留耳大神经56例均未出现耳垂麻木.结论:CT作为最常用术前辅助检查方法诊断准确性最高.根据术中冰冻切片快速诊断确定原发灶的手术范围、处理面神经以及颈部淋巴结,根据术后病理诊断确定是否配合术后放疗.术后常规加压包扎可减少涎瘘.保留耳大神经可防止耳垂麻木.