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[两名管乐器演奏者腮腺肿瘤的腮腺次全切除术,面神经功能保留]

[Subtotal parotidectomy for a parotid gland tumour in two players of wind instruments, with preservation of facial nerve function].

作者信息

Heeremans E H, Mastboom W J B

机构信息

Medisch Spectrum Twente, afd. Chirurgie, Postbus 50.000, 7500 KA Enschede.

出版信息

Ned Tijdschr Geneeskd. 2007 Mar 3;151(9):543-7.

Abstract

Two professional musicians, a 55-year-old clarinet player and a 58-year-old trumpet player, presented to the surgical outpatient clinic with a Warthin's tumour and a pleomorphic adenoma in the deep lobe of the parotid gland, respectively. The several branches of the facial nerve form the virtual plane between the superficial and deep lobes of the parotid gland. Due to the localisation of this nerve, parotid surgery entails a significant risk of neurapraxia of the facial nerve branches. Before the operation, both patients were informed carefully about both the necessity and the risks of surgical excision of parotid tumours. Even slight damage to the facial nerve during parotidectomy could have severe implications for their careers. Both underwent subtotal parotidectomy. Postoperatively, there was clinically a temporary minor marginal branch dysfunction in one patient. Pre- and postoperative electromyography did not indicate asymmetrical function of the facial muscles. A few weeks after the operations, both musicians could resume playing; subtotal parotidectomy can apparently be safely performed in players of wind instruments.

摘要

两名职业音乐家,一名55岁的单簧管演奏者和一名58岁的小号演奏者,分别因腮腺深叶的沃辛瘤和多形性腺瘤就诊于外科门诊。面神经的几个分支形成了腮腺浅叶和深叶之间的虚拟平面。由于该神经的定位,腮腺手术存在面神经分支发生神经失用症的重大风险。手术前,两名患者都被仔细告知了腮腺肿瘤手术切除的必要性和风险。腮腺切除术中即使面神经受到轻微损伤,也可能对他们的职业生涯产生严重影响。两人均接受了腮腺次全切除术。术后,一名患者临床上出现了暂时的轻微边缘支功能障碍。术前和术后的肌电图检查均未显示面部肌肉功能不对称。手术后几周,两名音乐家都可以恢复演奏;显然,对于管乐器演奏者来说,腮腺次全切除术可以安全进行。

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