Donovan D T, Conley J J
Laryngoscope. 1984 Mar;94(3):324-9. doi: 10.1288/00005537-198403000-00006.
Historically, parotid gland surgery has evolved from an operation of surgical enucleation to that of lateral lobectomy or total parotidectomy with facial nerve dissection. While the enucleation operation originally resulted in recurrence rates as high as 45% in some series, the technique of lateral lobectomy has resulted in recurrence rates of 2% in benign tumors. However, the currently recommended procedure of lateral lobectomy or total parotidectomy with facial nerve preservation for benign or low grade malignant tumors is not a pure en bloc resection in most cases, and in fact enucleation in part or total is often the reality of the operation. Tumor characterization, technical features, and operative findings of parotid gland surgery are examined in 100 consecutive cases. In over 60% of the cases, superficial or total parotidectomy with facial nerve preservation incorporated the principle of limited enucleation or capsular dissection at some point in the technique. The illusion that en bloc removal of parotid tumors with wide surgical margins is discredited. The reality of the procedure and the reasons for its success are examined.
从历史上看，腮腺手术已从单纯摘除术发展为外侧叶切除术或伴有面神经解剖的全腮腺切除术。虽然在某些系列研究中，摘除术最初导致的复发率高达45%，但外侧叶切除术技术使良性肿瘤的复发率降至2%。然而，目前推荐的针对良性或低级别恶性肿瘤的外侧叶切除术或伴有面神经保留的全腮腺切除术，在大多数情况下并非纯粹的整块切除，实际上部分或全部摘除往往是手术的实际情况。对连续100例腮腺手术的肿瘤特征、技术特点和手术结果进行了检查。在超过60%的病例中，保留面神经的浅叶或全腮腺切除术在技术的某些环节采用了有限摘除或包膜剥离的原则。整块切除腮腺肿瘤并带有宽手术切缘的观念已不可信。对该手术的实际情况及其成功原因进行了探讨。
