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腮腺浅叶良性肿瘤病例中面神经主干偏离正常解剖位置的发生率:一项手术发现及其意义

Incidence of Displacement of Facial Nerve Trunk from Normal Anatomical Position in Cases of Benign Tumour in Superficial Lobe of Parotid Gland: A Surgical Finding and its Significance.

作者信息

Kashyap Sushil Kumar, Tausif Mohd

机构信息

Maharani Laxmi Bai Medical College, Jhansi, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6367-6373. doi: 10.1007/s12070-021-03010-z. Epub 2022 Apr 15.

Abstract

Purpose of current study was to find out the incidence of displacement of facial nerve trunk from its normal anatomical position in relation to size and site of tumour in superficial lobe of parotid gland and its surgical significance. In the literature, the importance was given to the anatomical variations in branching pattern of facial nerve but not deviation. The knowledge of this variation is very important to prevent its injuries during superficial parotidectomy. The present study included 60 patients who underwent superficial parotidectomy for benign tumour involving the superficial lobe of parotid gland. The site and size of tumour noted pre operatively with help of ultrasound and CT scan and pathological diagnosis was made by FNAC. The superficial parotidectomy was performed and facial nerve was identified in all cases. In our study, 23 patients out of 60 were having displacement of facial nerve trunk from its normal anatomical position found during superficial parotidectomy. 10 out of 13 patients with tumor superior to facial nerve trunk were having displacement, 7 out of 18 had deviation with tumor inferior to nerve, 6 out of 29 patients had deviation of main trunk when the tumor involved whole of superficial lobe of gland.We conclude that the facial nerve trunk cannot be always traced at normal anatomical position by following the documented anatomical landmarks because of its displacement by tumour. Knowledge of this variation of facial nerve trunk can avoid the chances of damage to this nerve during superficial parotidectomy.

摘要

本研究的目的是找出腮腺浅叶肿瘤的大小和部位与面神经主干从其正常解剖位置移位的发生率及其手术意义。在文献中,人们重视面神经分支模式的解剖变异,而非移位情况。了解这种变异对于在腮腺浅叶切除术中防止面神经损伤非常重要。本研究纳入了60例因腮腺浅叶良性肿瘤接受腮腺浅叶切除术的患者。术前借助超声和CT扫描记录肿瘤的部位和大小,并通过细针穿刺抽吸活检进行病理诊断。所有病例均进行了腮腺浅叶切除术并识别了面神经。在我们的研究中,60例患者中有23例在腮腺浅叶切除术中发现面神经主干从其正常解剖位置移位。在13例肿瘤位于面神经主干上方的患者中,有10例出现移位;在18例肿瘤位于神经下方的患者中,有7例出现移位;在29例肿瘤累及整个腮腺浅叶的患者中,有6例主干出现移位。我们得出结论,由于肿瘤移位,按照记录的解剖标志不能总是在正常解剖位置找到面神经主干。了解面神经主干的这种变异可以避免在腮腺浅叶切除术中损伤该神经的可能性。

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本文引用的文献

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Displacement of the Facial Nerve by Deep Parotid Lobe Lesions in the Pediatric Population.小儿腮腺深叶病变对面神经的移位
Laryngoscope Investig Otolaryngol. 2019 Aug 19;4(5):550-553. doi: 10.1002/lio2.302. eCollection 2019 Oct.
6
Facial nerve localization in parotid surgery.腮腺手术中的面神经定位
ANZ J Surg. 2002 May;72(5):370. doi: 10.1046/j.1445-2197.2002.02387.x.
8
Localization of the facial nerve in parotid surgery.腮腺手术中面神经的定位
ANZ J Surg. 2001 Dec;71(12):701-2. doi: 10.1046/j.1445-1433.2001.02281.x.
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Landmarks for parotid gland surgery.腮腺手术的标志。
J Laryngol Otol. 2001 Feb;115(2):122-5. doi: 10.1258/0022215011907721.

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