Chang Jung Woo, Leem Soo Seong, Choi Hwan Jun, Lee Jang Hyun
From the *Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri; and †Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Soonchunghyang University College of Medicine, Cheonan, Republic of Korea.
Ann Plast Surg. 2017 May;78(5):507-510. doi: 10.1097/SAP.0000000000000885.
A functional superficial parotidectomy can maintain salivary function by preserving the Stensen duct. However, this technique still brings the possibility of salivary leakage, because major branches of the parotid duct from the resected site do not get ligated. To reduce this complication, this study introduces a modified technique with major branch ligation. From December 2008 to February 2015, 14 patients who underwent superficial parotidectomy were divided into 2 groups. Group A was treated with the modified functional superficial parotidectomy involving the major branch between the superficial lobe and parotid duct. Group B was treated with the conventional superficial parotidectomy without involving the major branch of the parotid duct. The clinical complications, period of Hemovac usage, and surgical duration were noted in each group. Two of 8 patients in group A had a major branch from Stensen duct that was ligated, and there was no evidence of salivary leakage or sialocele in any of the patients of group A, whereas group B contained 2 cases of salivary leakage, one of which became sialocele. Group A had a significantly longer Hemovac maintenance period than group B (P < 0.05), and the duration of surgery was also significantly different between the 2 groups (P < 0.05). Because a solitary major branch of the main parotid duct occasionally extends toward the superficial lobe, our modified technique-functional superficial parotidectomy with ligation of the major branch toward the superficial lobe-is a useful option for treatment of a benign parotid mass in such cases.
功能性腮腺浅叶切除术可通过保留腮腺主导管来维持唾液功能。然而,由于切除部位的腮腺导管主要分支未结扎,该技术仍存在涎瘘的可能性。为减少这一并发症,本研究引入了一种结扎主要分支的改良技术。2008年12月至2015年2月,14例行腮腺浅叶切除术的患者被分为两组。A组采用改良功能性腮腺浅叶切除术,结扎浅叶与腮腺导管之间的主要分支;B组采用传统腮腺浅叶切除术,不涉及腮腺导管的主要分支。记录每组的临床并发症、负压引流管使用时间及手术时长。A组8例患者中有2例结扎了来自腮腺主导管的主要分支,A组所有患者均无涎瘘或涎囊肿迹象,而B组有2例涎瘘,其中1例发展为涎囊肿。A组负压引流管留置时间显著长于B组(P < 0.05),两组手术时长也有显著差异(P < 0.05)。由于腮腺主导管的单个主要分支偶尔会延伸至浅叶,因此我们的改良技术——结扎向浅叶延伸的主要分支的功能性腮腺浅叶切除术——是治疗此类腮腺良性肿块的一种有效选择。