Li M M, Li S S, Tang Q L, Yang X M, He X B
Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Jul 7;55(7):658-663. doi: 10.3760/cma.j.cn115330-20191109-00678.
To evaluate the feasibility and efficacy of partial superficial parotidectomy with V-shaped incision by comparing with the Blair incision and hairline N-shaped incision. From January 2015 to January 2016, 60 patients (47 males and 13 females, with an age range of 25- 63 years) required for superficial partial parotid gland resection were randomly divided into three groups: V-shaped incision (VI) group, Blair incision (BI) group and hairline N-shaped incision (NI) group, with 20 cases in each group.Intraoperative, postoperative and follow-up indexes were compared between three groups. Operative time and drainage volume in the surgery of tumors at different sites in VI group were compared. SPSS18.0 software was used for statistic analysis. There were no statistically significant differences among the three groups in operative time, drainage volume, postoperative hospital stay, periauricular numbness, fistulas, pain score, facial palsy, and scar score at the 3rd month after surgery (>0.05). For appearance satisfaction score at the 6th month after surgery, VI group was better than BI group or NI group, with significant differences(VI group BI group: 9.00[8.00, 9.00] 5.00[4.00, 5.25], χ(2)=6.629, <0.001; VI group NI group: 9.00[8.00, 9.00] 7.00[6.00, 8.00], χ(2)=2.942, =0.010; BI group NI group: 5.00[4.00, 5.25] 7.00[6.00, 8.00], χ(2)=-3.687, =0.001). For tumors located in the front, upper and middle of parotid gland, there were no statistically significant differences in operative time and drainage volume between the three groups (>0.05). For tumors located at the lower part of parotid gland, the difference in operative time between the three groups was statistically significant (=7.278, =0.01). With pairwise comparison, operative time in VI group was longer than that in BI group or NI group, but there was no significant difference between BI group and NI group (VI group BI group: (181.00±22.89) min (132.50±9.01) min, =3.694, =0.004; VI group NI group:(181.00±22.89) min (149.00±15.94) min, =2.585, =0.025; BIgroup NI group, (132.50±9.01) min (149.00±15.94) min, =1.257, =0.235). For tumors located at the lower part of parotid gland, the differences in intraoperative drainage volume were not statistically significant between three groups (>0.05). There were no statistically significant differences in operative time and drainage volume in the surgery of tumors at different sites in VI group (>0.05). By use of V-shaped incision for the surgery of benign parotid gland tumors, the operation time of tumors located only in the lower part of the parotid gland will be prolonged. For tumors in different sites without increasing surgical complications, this modality can get good cosmetic effect.
通过与Blair切口和发际N形切口比较，评估V形切口行腮腺浅叶部分切除术的可行性和疗效。2015年1月至2016年1月，60例（男47例，女13例，年龄25 - 63岁）需行腮腺浅叶部分切除术的患者随机分为三组：V形切口（VI）组、Blair切口（BI）组和发际N形切口（NI）组，每组20例。比较三组术中、术后及随访指标。比较VI组不同部位肿瘤手术的手术时间和引流量。采用SPSS18.0软件进行统计分析。三组在手术时间、引流量、术后住院时间、耳周麻木、瘘管、疼痛评分、面神经麻痹及术后3个月瘢痕评分方面差异均无统计学意义（>0.05）。术后6个月外观满意度评分，VI组优于BI组和NI组，差异有统计学意义（VI组与BI组：9.00[8.00, 9.00]对5.00[4.00, 5.25]，χ(2)=6.629，<0.001；VI组与NI组：9.00[8.00, 9.00]对7.00[6.00, 8.00]，χ(2)=2.942，=0.010；BI组与NI组：5.00[4.00, 5.25]对7.00[6.00, 8.00]，χ(2)= - 3.687，=0.001）。对于位于腮腺前、上、中部的肿瘤，三组手术时间和引流量差异均无统计学意义（>0.05）。对于位于腮腺下部的肿瘤，三组手术时间差异有统计学意义（=7.278，=0.01）。两两比较，VI组手术时间长于BI组和NI组，但BI组与NI组差异无统计学意义（VI组与BI组：(181.00±22.89)分钟对(132.50±9.01)分钟，=3.694，=0.004；VI组与NI组：(181.00±22.89)分钟对(149.00±15.94)分钟，=2.585，=0.025；BI组与NI组，(132.50±9.01)分钟对(149.00±15.94)分钟，=1.257，=0.235）。对于位于腮腺下部的肿瘤，三组术中引流量差异无统计学意义（>0.05）。VI组不同部位肿瘤手术的手术时间和引流量差异均无统计学意义（>0.05）。采用V形切口行腮腺良性肿瘤手术，仅位于腮腺下部的肿瘤手术时间会延长。对于不同部位的肿瘤，在不增加手术并发症的情况下，该术式可获得良好的美容效果。
