Su J, Li P, Ji X B, Xie J H
Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People's Hospital, Guangzhou, 510180，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Jul;33(7):615-618. doi: 10.13201/j.issn.1001-1781.2019.07.010.
The aim of this study is to explore the clinical value of V-shaped concealed incision in parotid benign tumors surgery.Thirty-two patients with benign parotid tumors who were hospitalized from January 2016 to December 2017 were selected. All patients were treated with a V-shaped incision approach, starting from the anterior dermatoglyph of the tragus,extending downward to the earlobe and backward to the posterior earlobe, which formed an intersection point of the earlobe for parotid benign tumors,superficial lobectomy and facial nerve dissection.The greater auricular nerve and parotid masseter fascia were preserved,and the occult incision and prognosis were followed up for 1 year.①All patients achieved primary healing without salivary fistula and infection.The visual analogue scale (VAS) score of 32 patients with postoperative aesthetic satisfaction was 0.②Of the 32 patients,only 2 had temporary facial paralysis after operation, which returned to normal after 1 and 2 months,while the rest had no facial paralysis symptoms.③The posterior and inferior auricular branches of the greater auricular nerve were preserved in all the 32 patients, and the sensation of the lobe was numb to varying degrees after the operation. After 3 months,the sensation recovered completely.④Two patients had skin flushing and sweating on the affected cheek during masticatory exercise, while the others had no Frey syndrome. ⑤Five patients who were repaired with sternocleidomastoid muscle flaps during operation were reexamined one year after operation.There was no significant asymmetric depression on the operative side compared with the healthy side.⑥All the 32 patients were followed up for 1 year without recurrence.The V-shaped concealed incision is performed for benign tumor resection of the parotid gland. The incision approach is concealed and the scar is not obvious.The surgical field is clear and easy to operate.It is not easy to damage the facial nerve and the ear nerve. After the operation,the patient has a satisfactory facial shape.The parotid gland secretion function is basically normal,which is superior to the traditional S-shaped incision and has good clinical application value.
本研究旨在探讨V形隐蔽切口在腮腺良性肿瘤手术中的临床价值。选取2016年1月至2017年12月住院的32例腮腺良性肿瘤患者。所有患者均采用V形切口入路，起自耳屏前皮纹，向下延伸至耳垂并向后至耳垂后，在耳垂处形成交点用于腮腺良性肿瘤、浅叶切除术及面神经解剖。保留耳大神经和腮腺咬肌筋膜，并对隐蔽切口及预后进行1年随访。①所有患者均一期愈合，无涎瘘及感染。32例患者术后美学满意度视觉模拟评分（VAS）为0分。②32例患者中，仅2例术后出现暂时性面瘫，分别于1个月和2个月后恢复正常，其余患者无面瘫症状。③32例患者均保留了耳大神经的耳后及耳下分支，术后耳垂感觉不同程度麻木，3个月后感觉完全恢复。④2例患者在咀嚼运动时患侧面颊出现皮肤潮红及出汗，其余患者无味觉出汗综合征。⑤5例术中采用胸锁乳突肌瓣修复的患者术后1年复查，术侧与健侧相比无明显不对称凹陷。⑥32例患者均随访1年无复发。V形隐蔽切口用于腮腺良性肿瘤切除，切口入路隐蔽，瘢痕不明显，手术视野清晰，操作简便，不易损伤面神经及耳部神经，术后患者面部外形满意，腮腺分泌功能基本正常，优于传统S形切口，具有良好的临床应用价值。
