Wei H X, Chen S, Yang F, Wang X Y, Li C J, Li L J, Zhu G Q
Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2024 Feb 9;59(2):173-177. doi: 10.3760/cma.j.cn112144-20231025-00218.
To investigate the safety and feasibility of gasless total endoscopic resection of deep lobe parotid gland tumors via a postauricular hairline plus temporal approach. The approach was designed as: a 4 to 5 cm main incision was designed at the postauricular hairline, and a 0.5 cm auxiliary incision was designed in the temporal hairline. The operating cavity was established with the assistance of a special retractor. "Anterograde" dissection of the facial nerve was performed throughout the procedure, along with partial or total gland removal of the tumor. All 16 operations were successfully completed without conversion to open surgery. During the operation, the trunk and branches of the facial nerve were completely preserved, the tumor was completely removed, and the incision healed. Six patients had mild facial paralysis after operation, and recovered completely after 3 to 6 months. There was no salivary fistula, Frey syndrome, infection, or other complications. The postoperative incision was concealed and the aesthetic effect was good. The postauricular hairline plus temporal approach gasless total endoscopic parotidectomy is safe and feasible. This technique can achieve the complete dissection of the total trunk to the branches of the facial nerve, and has good access to the tumors located in any part of the parotid gland region. On the basis of radical resection of the tumor, it achieves minimally invasive and aesthetic improvement.
探讨经耳后发际加颞部入路行无充气全内镜下腮腺深叶肿瘤切除术的安全性及可行性。该入路设计为：在耳后发际设计4～5 cm主切口，在颞部发际设计0.5 cm辅助切口。在特制牵开器辅助下建立手术腔隙。术中全程行面神经“顺行”解剖，并部分或全部切除肿瘤所在腺体。16例手术均顺利完成，无一例中转开放手术。术中面神经主干及分支均完整保留，肿瘤完整切除，切口愈合良好。6例患者术后出现轻度面瘫，3～6个月后完全恢复。无涎瘘、Frey综合征、感染等其他并发症。术后切口隐蔽，美容效果良好。耳后发际加颞部入路无充气全内镜下腮腺切除术安全可行。该技术可实现面神经从主干到分支的完整解剖，对位于腮腺区任何部位的肿瘤均有良好的显露。在肿瘤根治性切除的基础上，实现了微创及美容改善。
