Ming Huawei, Yuan Zhongyi, Zhang Xingan, Jia Jiaxin, Wang Huadong, Chen Fangyuan, Tan Xiaoyao, He Yun
Department of Oral and Maxillofacial Surgery,the Second Clinical Medical College of North Sichuan Medical College,Nanchong Central Hospital,Nanchong,637000,China.
Department of Stomatology,the Second Clinical Medical College of North Sichuan Medical College,Nanchong Central Hospitalthe.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Sep;38(9):862-865;871. doi: 10.13201/j.issn.2096-7993.2024.09.017.
To investigate the clinical effect of retroauricular hairline approach in submandibular gland resection assisted by endoscope. A total of 18 patients with submandibular gland benign tumors treated in our hospital from September 2022 to September 2023 were selected. A 5 cm incision was designed in the retroauricular hairline, and the flap was turned over directly to the anterior edge of sternocleidomastoid muscle, then the flap was turned over to build the cavity through endoscopic surgery, and submandibular gland resection was completed with the assistance of endoscope. After operation, a negative pressure drainage was placed into the hairline, and the wound was closed by continuous intracutaneous suture. The clinical effect was evaluated after 3-6 months follow-up. All patients underwent submandibular gland resection with endoscopic assistance as planned, and none of them converted to submaxillary incision during operation. The operation time was 65-97 min, with an average of 75 min. Intraoperative bleeding was 10-20 mL, with an average of 14 mL.No tongue numbness, wound infection, or tumor recurrence occurred after operation. However, there were 10 patients with ear numbness and discomfort of auricle after surgery, which gradually recovered after 6-9 months of follow-up. Two patients had crooked mouth after surgery, and the symptoms were gradually relieved after follow-up. All incisions healed in stage I and were concealed. Endoscopic retroauricular hairline approach is a choice for submandibular gland resection with good cosmetic effect, less trauma and fewer complications.
探讨耳后发际缘入路在内镜辅助下下颌下腺切除术中的临床效果。选取2022年9月至2023年9月在我院治疗的18例下颌下腺良性肿瘤患者。在耳后发际缘设计一个5cm的切口,直接将皮瓣翻至胸锁乳突肌前缘,然后通过内镜手术将皮瓣翻转构建腔隙,在内镜辅助下完成下颌下腺切除。术后在发际处放置负压引流,采用连续皮内缝合关闭伤口。随访3 - 6个月后评估临床效果。所有患者均按计划在内镜辅助下完成下颌下腺切除术,术中无一例改为颌下切口。手术时间为65 - 97分钟,平均75分钟。术中出血10 - 20mL,平均14mL。术后无舌麻木、伤口感染或肿瘤复发情况发生。然而,术后有10例患者出现耳部麻木及耳廓不适,随访6 - 9个月后逐渐恢复。2例患者术后出现口角歪斜,随访后症状逐渐缓解。所有切口均一期愈合且隐蔽。内镜耳后发际缘入路是下颌下腺切除的一种选择,具有美容效果好、创伤小、并发症少的特点。