两种手术径路对颌下腺良性疾病面神经下颌缘支保护的效果分析

Effect analysis of two surgical approaches for the protection of the mandibular marginal branches of facial nerve in submandibular gland benign diseases

摘要:

目的 对比分析两种不同手术途径对颌下腺良性疾病面神经下颌缘支的保护效果。方法 选择2014年12月—2018年6月在四川省肿瘤医院初次手术的134例颌下腺良性疾病患者，分别采用不同手术入路进行颌下腺全切术，术式1：颈阔肌下翻瓣显露面神经下颌缘支；术式2：不显露面神经下颌缘支，仅在颌下腺表面分离；术后均随访6个月以上，统计两种不同途径手术的面神经下颌缘支损伤并发症出现的情况，运用t检验进行统计学对比分析。结果 运用术式1的患者中有2例出现暂时性口角歪斜，随访6个月后恢复正常，运用术式2的患者均无口角歪斜症状，两组并发症发生情况无统计学差异（P>0.05）。结论 两种手术途径均可有效保护面神经缘支，初学者建议加强颌下腺及面神经局部解剖知识。

Abstract:

Objective To compare the effects of two surgical approaches on the protection of the mandibular marginal branch of the facial nerve in benign submandibular gland diseases. Methods A total of 134 patients with benign submandibular gland diseases who underwent primary surgery in Sichuan cancer hospital from December 2014 to June 2018 were chosen. Total submandibular gland resection was performed through two approaches. The mandibular marginal branch of facial nerve was exposed by approach 1,but not exposed and only separated on the surface of submandibular gland by approach 2. The incidence of complications of mandibular marginal branch injuries in two different surgical approaches was statistically analyzed (the follow-up time was more than 6 months), and T test was used for statistical comparison. Results Among the patients using approach 1, 2 cases developed temporary askew mouth and returned to normal after 6 months of follow-up.Patients using approach 2 showed no symptoms of askew mouth. There was no statistical difference in the incidence of complications between the two groups(P>0.05). Conclusions Both surgical approaches can effectively protect the marginal branch of facial nerve. It is suggested that beginners should strengthen the local anatomy of submandibular gland and facial nerve.