Huber A, Schmid S, Fisch U
Klinik und Poliklinik für Otorhinolaryngologie, Hals- und Gesichtschirurgie, Universitätsspital Zürich.
HNO. 1994 Sep;42(9):553-8.
Twenty years experience of lateral parotidectomy as suspical treatment for pleomorphic adenoma are reviewed. All cases were managed at the ORL Clinic of the University of Zürich. 167 patients were followed for the frequency of possible recurrent tumors. Three patients (3/123) operated primarily developed a recurrences. Recurrences appeared after an average of 10 years, ranging from 1-30 years. The follow-up time varied from 1 to 21 years (average, 8 years). 39% (13 of 33) of the patients, who were re-operated for a recurrent tumor, developed another recurrence. The second recurrence appeared after an average of 10 years, ranging from 1-22 years. A persistent partial paresis of the facial nerve was found in 1% of the patients operated primarily and in 9% of the patients operated more than once. No paralysis was seen. We now choose "en-bloc" resections of pleomorphic adenomas without intra-operative opening of the tumor capsule as the treatment of choice. This treatment was possible in 83% of all cases, using a lateral parotidectomy. If tumor extends into the medial parotid lobe, total parotidectomy is required.
回顾了20年将腮腺外侧切除术作为多形性腺瘤可疑治疗方法的经验。所有病例均在苏黎世大学耳鼻喉科诊所进行处理。对167例患者进行了随访,以观察可能复发肿瘤的发生率。3例(3/123)初次手术患者出现复发。复发平均出现在10年后,范围为1至30年。随访时间从1年到21年不等(平均8年)。因复发肿瘤再次手术的患者中有39%(33例中的13例)出现了另一次复发。第二次复发平均出现在10年后,范围为1至22年。初次手术的患者中有1%出现持续性面神经部分麻痹,多次手术的患者中有9%出现该情况。未观察到完全性麻痹。我们现在选择在术中不打开肿瘤包膜的情况下对多形性腺瘤进行“整块”切除作为首选治疗方法。在所有病例中,83%的情况可以采用腮腺外侧切除术进行这种治疗。如果肿瘤延伸至腮腺内侧叶,则需要进行全腮腺切除术。