中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (3): 227-229.doi: 10.19438/j.cjoms.2017.03.007

• 论著 • 上一篇    下一篇

复发性腮腺多形性腺瘤的手术治疗及并发症预防

邓刚1，李晓光2，何悦2*，于德栋1*   

  1. 1.上海交通大学医学院附属第九人民医院·口腔医学院 口腔第二门诊部；
    2.口腔颌面-头颈肿瘤科，上海市口腔医学重点实验室，上海 200011
  • 收稿日期:2017-01-06 修回日期:2017-03-08 出版日期:2017-05-20 发布日期:2017-06-09
  • 通讯作者: 国家自然科学基金（51605289, 81570949, 81271112）；
    上海交通大学医学院附属第九人民医院院基金项目（syz2015-009）；上海交通大学医工交叉重点项目（YG2016ZD01）；上海交通大学医学院附属第九人民医院学科融合基金
  • 作者简介:邓刚（1974-），硕士，副主任医师，E-mail:75denggang@163.com
  • 基金资助:
    何悦，E-mail:william5218@126.com；于德栋，E-mail:yudedong@alumni.sjtu.edu.com。*共同通信作者

Surgical treatment of recurrent pleomorphic adenoma of parotid gland and prevention of complications

DENG Gang1, LI Xiao-guang2, HE Yue2, YU De-dong1.   

  1. 1.Second Dental Clinic；
    2.Department of Oromaxillofacial Head and Neck oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2017-01-06 Revised:2017-03-08 Online:2017-05-20 Published:2017-06-09

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被引次数

3

摘要： 目的：总结复发性腮腺多形性腺瘤的手术治疗经验，分析其预后影响因素。方法：回顾分析2010年1月—2015年1月于我院手术治疗的39例复发性腮腺多形性腺瘤患者的临床特点、手术方法、并发症、术后随访情况，采用SAS9.0软件包，运用Kaplan-Meier法及Log-rank分析其预后影响因素。结果：39例患者中，女14例（35.89%），男25例（64.10%）；年龄31~72岁（中位年龄45岁）。对其中26例（66.66%）采用腮腺全叶切除术治疗，11例（28.21%）采用腮腺浅叶切除术，2例（5.13%）采用腮腺部分切除术。6例患者因肿瘤黏连面神经，手术中予以部分切除。主要并发症为暂时性面瘫（29例，74.36%）及Frey综合征（9例，23.08%）。中位随访时间为2.1年，其中3例再次复发。预后与肿瘤大小及手术方式密切相关。结论：复发性腮腺多形性腺瘤手术预后与肿瘤大小及手术方式密切相关，建议采用浅叶或全叶切除术。神经往往与复发病灶关系密切，术中易造成神经损伤，必要时需要修复，术后定期随访十分重要。

关键词: 复发性多形性腺瘤, 手术, 面神经

Abstract: PURPOSE: To investigate the prognostic factors after surgical treatment of recurrent pleomorphic adenoma. METHODS: We retrospectively analyzed 39 patients diagnosed with recurrent pleomorphic adenoma who received surgical treatment in our hospital from January 2010 to January 2015. Clinical variables, imaging features and surgical outcomes were analyzed using SAS 9.0 software package. RESULTS: Among 39 patients, 14 (35.89%) were female while 25 (64.10%) were male. Their age ranged from 31 to 72 years old (median: 45). 66.66% (n=26) of the patients underwent total parotidectomy, while 11 patients (28.21%) underwent superficial parotidectomy and 2 (5.31%) with partial parotidectomy. Facial nerves were sacrificed in 6 patients due to nerve invasion by tumors. Postoperative complications were reported as temporary palsy (n=29, 74.36%) and Frey's syndrome (n=9, 23.08%). Median follow-up time was 2.1 years, during which 3 patients re-recurred. CONCLUSIONS: Recurrent pleomorphic adenoma is challenging from a surgical standpoint. Facial nerves are closely involved with these neoplasms. Close follow-up is necessary after operation.

Key words: Recurrent pleomorphic adenoma, Surgery, Facial nerve

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