Hong Ki Hwan, Yang Yun Su
Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University, Medical School, Chonju, Chonbuk, Korea.
Otolaryngol Head Neck Surg. 2008 Oct;139(4):530-4. doi: 10.1016/j.otohns.2008.01.008.
Most patients with benign submandibular disorders have been treated surgically without difficulty via the transcervical approach. An alternative to the standard transcervical approach has been reported such as an intraoral approach.
Retrospective chart review of the 77 patients with benign submandibular disorders. All patients underwent an excision of the submandibular gland via intraoral approach.
Early postoperative complications developed in 74.0% of the temporary lingual sensory paresis followed by 70.1% of temporary limitation of tongue movement. However, these complications soon resolved in all patients spontaneously. Two cases of postoperative bleeding and 1 case of abscess formation were developed. Whereas late complications developed in 4 cases of residual salivary gland and abnormal sense of mouth floor and 1 case of gustatory sweating (Frey's) syndrome.
The major advantages of this approach are no external scar, no injury to the marginal mandibular nerve. The disadvantage is a more difficult dissection to transcervical approach before proper expert, especially in the severe adhesion of salivary gland to surrounding tissue.
大多数患有良性下颌下腺疾病的患者通过经颈入路手术治疗并无困难。已有报道称可采用口内入路等标准经颈入路的替代方法。
对77例患有良性下颌下腺疾病的患者进行回顾性病历审查。所有患者均通过口内入路进行下颌下腺切除术。
术后早期并发症中，74.0%出现暂时性舌感觉麻痹，70.1%出现暂时性舌运动受限。然而，所有患者的这些并发症均很快自行缓解。出现2例术后出血和1例脓肿形成。晚期并发症方面，有4例出现残留唾液腺和口底异常感觉，1例出现味觉出汗（弗雷氏）综合征。
该入路的主要优点是无外部瘢痕，不损伤下颌缘支神经。缺点是在没有合适专家的情况下，与经颈入路相比解剖操作更困难，尤其是在唾液腺与周围组织严重粘连的情况下。
