Min Ruan, Zun Zhang, Siyi Li, Wenjun Yang, Jian Sun, Chenping Zhang
Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomotology, PR China.
Br J Oral Maxillofac Surg. 2013 Oct;51(7):615-9. doi: 10.1016/j.bjoms.2013.01.009. Epub 2013 Feb 9.
The most widely accepted treatment for neoplasms of the submandibular gland usually involves excision of the entire gland. Our aim was to establish a gland-preserving operation for benign tumours of the submandibular gland and evaluate its efficacy. We treated 40 patients from January 2007 to December 2008 with benign submandibular gland tumours who were listed to have an operation that either preserved the gland or sacrificed it. Duration of operation, extent of injury to the nerve, postoperative function of the gland, aesthetic appearance, and recurrence were assessed. We found no significant difference in baseline characteristics among the 20 patients in each group (19 men; 21 women, mean (SD) age of 34 (33.8 ± 5.72) years. The extent of injury to the lingual nerve and submandibular branch, together with deformities of the facial contour, were significantly less in the group in which the gland was preserved. Postoperative salivary production and overall patients' satisfaction were also better in that group. There was no recurrence in either group during the follow up period of 38 months-5 years. The gland-preserving procedure has advantages over the typical approach in which the gland is sacrificed. There is less risk of injury to the nerve, less deformity of the facial contour, better preservation of function, and patients are more satisfied. The gland-preserving technique should therefore be the first choice for management of benign submandibular tumours.
目前，治疗下颌下腺肿瘤最广泛采用的方法通常是切除整个腺体。我们的目的是建立一种针对下颌下腺良性肿瘤的保腺手术，并评估其疗效。我们对2007年1月至2008年12月期间的40例下颌下腺良性肿瘤患者进行了治疗，这些患者被安排接受保腺或切腺手术。评估了手术时间、神经损伤程度、术后腺体功能、美观程度和复发情况。我们发现每组20例患者的基线特征无显著差异（19例男性；21例女性，平均（标准差）年龄为34（33.8±5.72）岁）。保腺组舌神经和下颌下支的损伤程度以及面部轮廓畸形明显较轻。该组术后唾液分泌和患者总体满意度也更高。在38个月至5年的随访期内，两组均无复发。与切除腺体的传统方法相比，保腺手术具有优势。神经损伤风险更低，面部轮廓畸形更小，功能保留更好，患者更满意。因此，保腺技术应成为下颌下腺良性肿瘤治疗的首选方法。
