Roh Jong-Lyel
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Gyeonggi-do, Seongnam, Republic of Korea.
Eur J Surg Oncol. 2022 Jan;48(1):21-26. doi: 10.1016/j.ejso.2021.08.030. Epub 2021 Aug 28.
Gland-preserving surgery is often used for benign tumours in the parotid gland. Partial superficial parotidectomy via a periauricular incision may bring satisfactory cosmetic outcomes but the disease control outcome remains unrevealed. This study evaluated functional and disease control outcomes after gland-preserving surgery via periauricular incision for pleomorphic adenoma of the parotid gland.
This longitudinal study included 248 consecutive patients with parotid pleomorphic adenoma who underwent the preservation of most normal parotid tissues and the facial nerve combined with the en-bloc resection of tumours via periauricular incision. Postoperative complications, subjective satisfaction, salivary function, and tumour recurrence were assessed in each patient. The secretory function of the salivary gland was measured using salivary scintigraphy at 6 months after surgery, and ultrasonography was regularly followed.
Median tumour size was 2.5 cm (range, 0.8-5.2 cm) and median operation time was 55 min (range, 39-88 min). All tumours were safely removed by gland-preserving surgery via periauricular incision without extension to Blair or hairline incision and tumour spillage. Temporary and permanent paralysis of the facial nerve was 14 (5.6%) and none of the study patients, respectively. Postoperative complications were minor and Frey's syndrome was found in 6 (2.4%) patients. The Secretary function of the affected gland was equal to that of the unaffected gland. No patients had a recurrence for a median follow-up of 78 months (range, 24-126 months).
Functional gland-preserving surgery via periauricular incision can treat pleomorphic adenoma in the parotid gland with satisfactory functional, cosmetic, and disease control outcomes.
保留腺体手术常用于腮腺良性肿瘤。经耳周切口行部分腮腺浅叶切除术可带来令人满意的美容效果，但疾病控制效果仍不明确。本研究评估了经耳周切口行保留腺体手术治疗腮腺多形性腺瘤后的功能和疾病控制效果。
这项纵向研究纳入了248例连续的腮腺多形性腺瘤患者，他们通过耳周切口进行了大部分正常腮腺组织和面神经的保留，并整块切除肿瘤。评估了每位患者的术后并发症、主观满意度、唾液功能和肿瘤复发情况。术后6个月使用唾液闪烁显像测量唾液腺的分泌功能，并定期进行超声检查。
肿瘤中位大小为2.5 cm（范围0.8 - 5.2 cm），中位手术时间为55分钟（范围39 - 88分钟）。所有肿瘤均通过经耳周切口的保留腺体手术安全切除，未扩展至Blair或发际线切口，也无肿瘤溢出。面神经暂时性和永久性麻痹分别为14例（5.6%）和本研究无患者出现。术后并发症轻微，6例（2.4%）患者出现了Frey综合征。患侧腺体的分泌功能与未患侧腺体相当。中位随访78个月（范围24 - 126个月），无患者复发。
经耳周切口行保留腺体功能的手术可治疗腮腺多形性腺瘤，在功能、美容和疾病控制方面均有令人满意的效果。
