Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: A 25‐year experience with 229 patients
Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: A 25‐year experience with 229 patients
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保守性腮腺全切除术治疗腮腺原发性良性多形性腺瘤：229 名患者 25 年的经验
DOI：
10.1288/00005537-199412000-00011
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
D. Brasnu
中科院分区：
文献类型：
--
作者：
H. Laccourreye;O. Laccourreye;R. Cauchois;V. Jouffre;M. Menard;D. Brasnu
回顾了229例腮腺原发性良性多形性腺瘤（PBPA）患者行保守性腮腺全切除术的25年经验。本研究的重点是生存率，发病率，PBPA复发，术后面神经功能障碍，弗雷氏综合征。本研究中未发生手术死亡。术后出血、血肿、血清肿、皮肤坏死、耳大神经鞘瘤和瘢痕疙瘩的总发生率分别为1.7%、6.1%、4.8%、0.9%、15.7%和8.3%。5年、10年、15年和20年PBPA控制精算率为99.6%。暂时性面瘫和面瘫的总发生率分别为64.6%和5.6%。Kaplan-Meier精算分析表明，轻瘫恢复至术后18个月。永久性面瘫和瘫痪的总发生率分别为3.9%和0%。性别、年龄、PBPA大小、PBPA位置、PBPA与面神经接触、PBPA意外溢出或外科医生经验等变量均与PBPA复发和面神经功能障碍无统计学相关性。Frey综合征的总发病率为65.9%。Kaplan-Meier精算分析表明，至少需要5年随访来评估Frey综合征的发生率。Frey综合征患者的平均年龄在统计学上较低。
A 25‐year experience with total conservative parotidectomy for primary benign pleomorphic adenoma (PBPA) of the parotid gland in a consecutive series of 229 patients has been reviewed. This study focuses on survival, morbidity, PBPA recurrence, postoperative facial nerve dysfunction, and Frey's syndrome. Surgical death was never encountered in this study. The overall incidence for postoperative hemorrhage, hematoma, seroma, skin necrosis, great auricular nerve schwannoma, and keloid scar was 1.7%, 6.1%, 4.8%, 0.9%, 15.7%, and 8.3%, respectively. Five‐, 10‐, 15‐, and 20‐year PBPA control actuarial rate was 99.6%. The overall incidence for temporary facial paresis and paralysis was 64.6% and 5.6%, respectively. Kaplan‐Meier actuarial analysis demonstrated that paresis recovery was noted until the eighteenth postoperative month. The overall incidence for permanent facial paresis and paralysis was 3.9% and 0%, respectively. None of the following variables—sex, age, PBPA size, PBPA location, PBPA contact with the facial nerve, inadvertent PBPA spillage, or surgeon's experience— was statistically related to PBPA recurrence and facial nerve dysfunction. The overall incidence for Frey's syndrome was 65.9%. Kaplan‐Meier actuarial analysis demonstrated the need for a minimal 5‐year follow‐up to assess Frey's syndrome incidence. The mean age was statistically lower in patients presenting with Frey's syndrome.