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[一种治疗颈部肿瘤的新型手术技术:通过小切口内镜辅助切除良性肿瘤]

[A novel surgical technique for neck neoplasms: endoscope-assisted resection of benign tumors via a small concealed incision].

作者信息

Shi L, Song X B, Wang K T, Liu C, Tan W Y, Wang Y

机构信息

Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University, Jinan 250012, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2020 Feb 9;55(2):115-118. doi: 10.3760/cma.j.issn.1002-0098.2020.02.008.

DOI:10.3760/cma.j.issn.1002-0098.2020.02.008
PMID:32074673
Abstract

To introduce a new surgical procedure for the treatment of neck benign tumors by endoscopic techniques. Seventeen patients with neck benign tumor underwent surgery by endoscope through a concealed incision in Department of Oral and Maxillofacial Surgery, Qilu Hospital of Shandong University from January 2018 to August 2019 were analyzed, which included 3 cases of tumor in the submental area, 2 cases in submandibular region, 9 cases in lower pole region of parotid gland, 1 case in superior region of sternocleidomastoid muscle, 1 case in central region of sternocleidomastoid muscle, 1 case in inferior region of sternocleidomastoid muscle. All patients underwent routine preoperative examination and CT examination to evaluate tumor size, boundary, morphology and nature. According to the area where the tumor located, concealed incisions in different sites were designed. Lumps in the submental area and submandibular area were treated with oral vestibular sulcus incision. Benign tumors located in the lower pole region of parotid gland and the sternocleidomastoid muscle region were treated with approach of the short hidden postauricular incision. During the operation, the self-developed "maxillofacial suspension device" was used to provide the operating space. The tumors were completely removed with endoscope and all patients were followed up every 3 months. All surgical procedures were performed as expected. Visual analogue scale (VAS) was 9.3 on average at 3 months after operation, all the patients were satisfied with the incision design and the cosmetic effect. No recurrences were found in patients with a follow-up period ranged from 1-15 months. These studies have shown that endoscope-assisted neck benign tumor resection is a surgical procedure with covert incision and good cosmetic results.

摘要

介绍一种通过内镜技术治疗颈部良性肿瘤的新手术方法。分析了2018年1月至2019年8月在山东大学齐鲁医院口腔颌面外科经隐蔽切口采用内镜手术治疗的17例颈部良性肿瘤患者,其中颏下区肿瘤3例,下颌下区2例,腮腺下极区9例,胸锁乳突肌上区1例,胸锁乳突肌中区1例,胸锁乳突肌下区1例。所有患者均接受常规术前检查及CT检查,以评估肿瘤大小、边界、形态及性质。根据肿瘤所在区域,设计不同部位的隐蔽切口。颏下区及下颌下区肿块采用口前庭沟切口治疗。位于腮腺下极区及胸锁乳突肌区的良性肿瘤采用耳后短隐蔽切口入路治疗。术中使用自行研制的“颌面悬吊装置”提供操作空间。在内镜下将肿瘤完整切除,所有患者每3个月随访1次。所有手术操作均按预期进行。术后3个月视觉模拟评分(VAS)平均为9.3分,所有患者对切口设计及美容效果均满意。随访1 - 15个月,患者均未复发。这些研究表明,内镜辅助下颈部良性肿瘤切除术是一种切口隐蔽、美容效果良好的手术方法。

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