Cracchiolo Jennifer R, Shaha Ashok R
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Otolaryngol Clin North Am. 2016 Apr;49(2):415-24. doi: 10.1016/j.otc.2015.10.007. Epub 2016 Feb 17.
Parotidectomy for parotid cancer includes management of primary salivary cancer, metastatic cancer to lymph nodes, and direct extension from surrounding structures or cutaneous malignancies. Preoperative evaluation should provide surgeons with enough information to plan a sound operation and adequately counsel patients. Facial nerve sacrifice is sometimes required; but in preoperative functioning nerves, function should be preserved. Although nerve involvement predicts poor outcome, survival of around 50% has been reported for primary parotid malignancy. Metastatic cutaneous squamous cell carcinoma is a high-grade aggressive histology whereby local control for palliation with extended parotidectomy can be achieved; however, overall survival remains poor.
腮腺癌的腮腺切除术包括原发性涎腺癌、淋巴结转移性癌以及周围结构或皮肤恶性肿瘤直接侵犯的处理。术前评估应向外科医生提供足够信息，以便规划合理的手术并充分为患者提供咨询。有时需要牺牲面神经；但对于术前功能正常的神经，应保留其功能。虽然神经受累预示预后不良，但据报道原发性腮腺恶性肿瘤的生存率约为50%。转移性皮肤鳞状细胞癌是一种高分级侵袭性组织学类型，通过扩大腮腺切除术可实现局部姑息性控制；然而，总体生存率仍然较差。
