[Application of retroauricular sulcus incision in the operation of benign tumors in the deep lobe of parotid gland]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Dec 7;58(12):1238-1242. doi: 10.3760/cma.j.cn115330-20231008-00126.
[Article in Chinese]

Abstract

Objective: To investigate the application of retroauricular groove incision in the resection of benign tumors in the deep lobe of parotid. Methods: From January 2017 to January 2022, 19 patients (11 males and 8 females, age ranged from 17 to 69 years, with a median age of 48) with benign tumor in the deep lobe of parotid gland underwent parotidectomy through retroauricular sulcus incision in Linyi People's Hospital. Among them, 17 cases with tumor diameter≤4.0 cm underwent simple retroauricular groove incision, and 2 cases were dumbbell type with tumor diameter>4.0 cm on the medial side of mandible protruding into the parapharyngeal space, in which the deep lobe and tumor of parotid gland were resected through retroauricular sulcus incision combined with intraoral incision. Results: Tumors were completely removed through retroauricular sulcus incision in 17 cases, and dumbbell type tumors were removed through retroauricular sulcus incision combined with intraoral incision in 2 cases. Postoperative pathological examinations showed pleomorphic adenoma in 13 cases, basal cell adenoma in 4 cases and Warthin's tumor in 2 cases. Temporary mandibular marginal branch paralysis occurred in 2 patients and returned to normal 3 weeks after operation. All incisions healed in Phase I. By following-up of 1-5 years with a median follow-up time of 3.1 years, none of the patients had Frey syndrome, salivary fistula, other complications and tumor recurrence. The patients and their families were satisfied with the postoperative facial appearances. Conclusion: The retroauricular groove approach can not only preserve the function of parotid superficial lobe and facial nerve, but also has less trauma, less tissue defect and hidden scar. As the advantages of less complication, low recurrence rate and good cosmetic effect, the incision is worthy of clinical application.

目的: 分析探讨耳后沟切口在腮腺深叶良性肿瘤切除术中的应用。 方法: 选取2017年1月—2022年1月在临沂市人民医院接受耳后沟切口行腮腺深叶良性肿瘤切除手术的19例患者为研究对象,其中男11例,女8例,年龄17~69岁,中位年龄48岁。其中17例肿瘤直径≤4.0 cm,行单纯耳后沟切口;2例为哑铃型,下颌骨内侧肿瘤前后径>4.0 cm,肿瘤突向咽旁间隙,经耳后沟切口联合口内切口切除腮腺深叶及肿瘤。 结果: 17例肿瘤经耳后沟切口完全摘除,2例哑铃型肿瘤经口内切口取出,术后病理多形性腺瘤13例、基底细胞腺瘤4例、Warthin瘤2例。2例患者出现暂时性下颌缘支麻痹,术后3周恢复至正常。所有患者全部一期愈合。经过1~5年的随访,中位随访时间3.1年,患者均未出现Frey综合征和涎瘘,均未出现其他并发症,肿瘤无复发。患者及家属对术区面部外形、切口瘢痕外观满意。 结论: 耳后沟切口入路应用于腮腺深叶良性肿瘤的手术治疗,不仅保留了腮腺浅叶及面神经的功能,同时具有创伤小、组织缺损少、瘢痕隐蔽、并发症及复发率低、美容效果好等优点,值得临床推广应用。.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cicatrix
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms*
  • Parotid Gland / surgery
  • Postoperative Care
  • Surgical Wound*
  • Young Adult