关键词: 面神经, 腮腺良性肿瘤, 区域性腮腺切除术, 逆行解剖法, 顺行解剖法, 中段解剖法

Abstract:

Objective To propose and evaluate the clinical effect of midpiece facial nerve dissection through transparotid approach in regional parotidectomy. Methods A total of 136 patients with benign parotid tumors were categorized into three groups according to the way of facial nerve dissection: anterograde dissection from main trunk (anterograde, n=70), retrograde dissection from distal branches (retrograde, n=34), and midpiece dissection through transparotid approach (middle dissection, n=32). Surgery duration, facial nerve injury, salivary fistula, earlobe sensation, Frey’s syndrome, and aesthetic evaluation were compared. Results The surgery duration in the middle dissection group was significantly shorter than that in the other two groups. The proportion of salivary fistula was higher in the anterograde group (9 cases, 12.9%; P<0.05) compared with that in the other groups. Postoperative facial nerve injury was similar between the middle dissection (1 case, 3.1%) and anterograde groups (3 cases, 4.3%) with lower injury rate compared with the retrograde group (7 cases, 20.6%). The anterograde group had more cases of hypoesthesia of the earlobe (12 cases, 17.1%; P<0.05) than the other two groups. Aesthetic score was higher in the anterograde and middle dissection groups compared with that in the retrograde group (P<0.05). Conclusion Midpiece facial nerve dissection is technically feasible and clinically viable in regional parotidectomy.

Key words: facial nerve, parotid gland benign tumor, regional parotidectomy, anterograde dissection, retrograde dissection, midpiece dissection