Chevalier D, Loche V, Darras J A, Apko-Allavo J, Desaulty A, Piquet J J
Service d'ORL, Hôpital Claude Huriez, CHU Lille.
Ann Otolaryngol Chir Cervicofac. 1996;113(2):56-60.
Between 1967 and 1994, 344 patients were treated with total conservative parotidectomy for benign pleomorphic adenoma of the parotid gland. Our retrospective study focuses on a sixty-two patients group treated for recurrence after biopsy, enucleation or total parotidectomy. Twenty-two patients underwent a systematic total parotidectomy after biopsy (n = 7) or enucleation (n = 15). Twenty-nine patients were treated with total parotidectomy for local recurrence after enucleation. The mean time before this treatment was 8 years-9 months. In the third group, 11 patients, (7 patients from our institution), were surgically treated for recurrence after total parotidectomy. After enucleation, the recurrence rate was high and insufficient margins were found in 27% of the cases. In this group, a multicentric recurrence was found in 45% of the cases. In our own experience, recurrence after total parotidectomy was noted in 2.4%. The surgical salvage was performed with enucleation after identification of the branches of the facial nerve. The operative microscope was usefull. In 1 case, a second recurrence occured, and in 1 case iterative recurrence was noted. The local control rate after total parotidectomy was 99.6% (292/293). Total conservative parotidectomy is, for us, the treatment of choice for pleomorphic adenoma of the parotid gland.
1967年至1994年间,344例患者因腮腺良性多形性腺瘤接受了全腮腺保留切除术。我们的回顾性研究聚焦于一组62例因活检、剜除术或全腮腺切除术后复发而接受治疗的患者。22例患者在活检(n = 7)或剜除术(n = 15)后接受了系统性全腮腺切除术。29例患者因剜除术后局部复发接受了全腮腺切除术。此次治疗前的平均时间为8年9个月。在第三组中,11例患者(7例来自我们机构)因全腮腺切除术后复发接受了手术治疗。剜除术后复发率较高,27%的病例切缘不足。在该组中,45%的病例发现多中心复发。根据我们自己的经验,全腮腺切除术后的复发率为2.4%。在识别面神经分支后,通过剜除术进行手术挽救。手术显微镜很有用。1例出现第二次复发,1例出现反复复发。全腮腺切除术后的局部控制率为99.6%(292/293)。对我们来说,全腮腺保留切除术是腮腺多形性腺瘤的首选治疗方法。