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良性病变腮腺手术的外科治疗及并发症:2012 年至 2021 年回顾性分析。

Surgical management and side effects of parotid gland surgery for benign lesions: a retrospective analysis of our experience from 2012 to 2021.

机构信息

Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy.

Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy.

出版信息

Br J Oral Maxillofac Surg. 2023 Jul;61(6):411-415. doi: 10.1016/j.bjoms.2023.03.011. Epub 2023 Mar 31.

Abstract

Surgery is the treatment of choice for tumours in the parotid gland. We evaluated complications following parotid surgery. We conducted a retrospective study on 554 patients undergoing parotid surgery for benign parotid tumours from 2012 to 2021. We analysed complication rates between extracapsular dissection (ECD) and superficial parotidectomy (SP). We found 19 capsular ruptures in patients undergoing ECD (5.34%) and five among those undergoing SP (2.52%) [p < 0,05]; 16 cases of temporary facial paralysis among those undergoing ECD (4.49%) and 35 in patients undergoing SP (17.67%) [p < 0,05]; and eight instances of permanent facial nerve paralysis in patients undergoing ECD (2.25%) [p > 0,05] and 13 in patients undergoing SP (6.56%). Among the mid-term complications described were: 22 salivary fistulas among patients operated with ECD (6.18%) [p > 0,05] and 17 in patients with SP (8.58%) 17 sialoceles in those who underwent ECD (4.77%) and seven with SP (3.53%) [p > 0,05]. Regarding late complications, we found: surgical wound dehiscence, pathological scarring (keloid), Frey's syndrome, and recurrence, which affected 45 patients with ECD (12.64%) and 21 with SP for dehiscence (10.6%) [p < 0,05]; 28 keloids in patients with ECD (7.86%) and 15 in patients with SP (7.57%) [p > 0,05]; 12 cases of Frey's syndrome in patients with ECD (3.37%) and 36 with SP (18.18%) [p < 0,05]; and finally 22 recurrences in patients who underwent ECD (6.18%) and 13 in patients who underwent SP (6.56%) [p > 0,05], including 30 in the 273 patients with pleomorphic adenoma and five in the 214 patients with Warthin's tumour. We can conclude that the onset of the different complications after parotid gland surgery are related to the surgery performed. Our data confirm that there is a tight relationship between type of surgery performed and type of complication.

摘要

手术是治疗腮腺肿瘤的首选方法。我们评估了腮腺手术后的并发症。我们对 2012 年至 2021 年间因良性腮腺肿瘤接受腮腺手术的 554 名患者进行了回顾性研究。我们分析了囊外解剖(ECD)和腮腺浅叶切除术(SP)之间的并发症发生率。我们发现,在接受 ECD 的患者中,有 19 例囊破裂(5.34%),在接受 SP 的患者中,有 5 例(2.52%)(p<0.05);在接受 ECD 的患者中,有 16 例暂时性面瘫(4.49%),在接受 SP 的患者中,有 35 例(17.67%)(p<0.05);在接受 ECD 的患者中,有 8 例永久性面神经瘫痪(2.25%)(p>0.05),在接受 SP 的患者中,有 13 例(6.56%)。在描述的中期并发症中,有 22 例接受 ECD 手术的患者出现涎瘘(6.18%)(p>0.05),有 17 例接受 SP 手术的患者出现涎瘘(8.58%);有 17 例接受 ECD 手术的患者出现唾液囊肿(4.77%),有 7 例接受 SP 手术的患者出现唾液囊肿(3.53%)(p>0.05)。关于晚期并发症,我们发现:手术切口裂开、病理性瘢痕(瘢痕疙瘩)、Frey 综合征和复发,接受 ECD 的患者中有 45 例(12.64%)和接受 SP 的患者中有 21 例(10.6%)(p<0.05);接受 ECD 的患者中有 28 例瘢痕疙瘩(7.86%)和接受 SP 的患者中有 15 例(7.57%)(p>0.05);接受 ECD 的患者中有 12 例 Frey 综合征(3.37%)和接受 SP 的患者中有 36 例(18.18%)(p<0.05);最后,接受 ECD 的患者中有 22 例复发(6.18%)和接受 SP 的患者中有 13 例复发(6.56%)(p>0.05),其中 30 例患者为多形性腺瘤,5 例患者为沃辛瘤。我们可以得出结论,腮腺手术后不同并发症的发生与手术方式有关。我们的数据证实,手术类型与并发症类型之间存在紧密的关系。

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