Leonetti J P, Smith P G, Anand V K, Kletzker G R, Hartman J M
Loyola Center for Cranial Base Surgery, Maywood, IL.
Otolaryngol Head Neck Surg. 1993 Mar;108(3):270-6. doi: 10.1177/019459989310800311.
Circumferential growth of parotid neoplasms may involve the external auditory meatus posteriorly, the floor of the middle cranial fossa superiorly, and the neurovascular structures of the jugular foramen medially. Inadequate tumor resection in these anatomically complex regions will result in local disease recurrence at the lateral skull base. A subtotal petrosectomy approach has been combined with a standard total parotidectomy in the management of 27 patients with aggressive parotid tumors. Twenty-two patients had malignant lesions and 10 individuals had recurrent disease. The resultant conductive hearing loss is outweighed by the following advantages of this technique: (1) the ability to obtain tumor-free bony margins, (2) proximal intratemporal facial nerve identification, (3) vascular control of the jugular bulb and petrous carotid artery, and (4) the dissection and protection of cranial nerves IX through XII. Our series of 27 patients will be detailed with an emphasis on surgical technique and overall patient results.
腮腺肿瘤的周向生长可能会累及后方的外耳道、上方的中颅窝底以及内侧的颈静脉孔神经血管结构。在这些解剖结构复杂的区域，肿瘤切除不充分会导致侧颅底局部疾病复发。在27例侵袭性腮腺肿瘤的治疗中，采用了部分岩骨切除术联合标准全腮腺切除术的方法。22例患者有恶性病变，10例患者有复发性疾病。该技术的以下优点超过了由此导致的传导性听力损失：（1）能够获得无肿瘤的骨质边缘；（2）识别颞内面神经近端；（3）控制颈静脉球和岩骨颈动脉的血管；（4）解剖和保护第九至第十二对脑神经。我们将详细介绍这27例患者的系列病例，重点是手术技术和患者的总体结果。
