耳前–耳后V形切口与改良Blair切口在腮腺肿瘤手术中的比较

Comparison of Anterior-Posterior V-Incision and Modified Blair Incision in Parotid Tumor Surgery

摘要: 目的：通过与改良Blair切口比较，探讨耳前–耳后V形切口在腮腺肿瘤手术中的可行性与安全性。方法：回顾分析浙江大学医学院附属第二医院2017年10月至2019年10月因腮腺良性肿瘤而接受手术的39例患者。其中19例采用耳前–耳后V形切口，20例采用改良Blair切口。术后对患者进行长达1年的跟踪随访，比较两组患者在手术时间、引流情况、并发症发生率以及疤痕评分之间的差异。结果：耳前–耳后V形切口组的手术时间、术后引流量小于改良Blair切口组(P < 0.01)，且术后各个阶段的疤痕满意度均优于改良Blair切口组(P < 0.01)。术后涎瘘、耳垂麻木、面神经功能障碍、味觉出汗综合征等并发症的发生率以及肿瘤复发率在两组间无显著性差异(P > 0.05)。结论：耳前–耳后V形切口入路下切除耳周附近小体积(直径 ≤ 3 cm)腮腺浅叶良性肿瘤是安全可行的，且相较改良Blair切口其创伤更小，运用更为灵活，术后美观效果更好，可在临床上推荐使用。

Abstract: Objective: To investigate the feasibility and safety of anterior-posterior V-shaped incision in parotid tumor surgery by comparing it with modified Blair incision. Methods: Thirty-nine patients who underwent surgery for benign parotid tumors from October 2017 to October 2019 at the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed. Among them, 19 cases were operated with an anterior-posterior V-shaped incision and 20 cases were operated with a modified Blair incision. Patients were followed up for up to 1 year after surgery to compare the differences between the two groups in terms of operative time, drainage, complication rates, and scar scores. Results: The operative time and postoperative drainage of the anterior-posterior V-shaped incision group were significantly less than that of the modified Blair incision group (P < 0.01), and the satisfaction of the scars at all postoperative stages was significantly better than that of the modified Blair incision group (P < 0.01). The incidence of postoperative complications such as salivary fistula, earlobe numbness, facial nerve dysfunction, Frey’s syndrome, and recurrence were not significantly different between the two groups (P > 0.05). Conclusion: The resection of small benign superficial parotid tumors (diameter ≤ 3 cm) around the periauricular region under anterior-posterior V-shaped incision is safe and feasible, and it is less invasive and more flexible than modified Blair incision.