The Observation Of The Efficacy To Benign Tumour Of Parotid Gland Defect With The Cylindrical Parotidectomy

Objective:It has been reported that salivary gland tumours account for 5% of head and neck tumours. Parotid gland as the first major salivary glands, the occurrence of tumor is also located in the first place.About 75% of all patients which have parotid gland tumours are benign in the clinical. Parotid gland has special anatomical and physiological functions, and the study found that most of the parotid benign tumor capsular incomplete and easy recurrence of planting.Althouth surgery is the preferred treatment method, but based on the above reasons, the recurrence after surgery, facial nerve paralys, salivary fistula, Frey ’s syndrome, ear lobe numbness has been plagued by problems clinical doctor, bring great challenge to better postoperative recovery. After the technique of enucleation, surgical procedure,like superficial parotidectomy(SP),partial superficial parotidectomy(PSP),extra-capsular resection(EDC) have been put forward as the treatment methods. Based on clinical experience, SP dramtically reduced the high rates of tumour recurrence,but with the high rates of incidence of postoperative complications. PSP has fewer complications,by contrast, but vitreoretinal surgery strictly. The main trunk of facial never must be exposed and all branches or only the branch or branches of the nerve adjadent to the tumour are dissected in these two kinds of operative methods,which can increase the rate of the mechanical damage of facial nerve. Although EDC not dissect the facial nerve, but it is lack of theory support from operation safety margin,so clinical promotion is too difficulty.So,the very important part is making parotid surgery a compromise between adequate tumour excision and reduce the complications for clinical physicians. The aim of this article is to assess the clinical value of the new technique of parotid surgery called cylindricalparotidectomy and effect of salivary fistula after cooperate with simple suction drain(17kPa, drainage tube 12#),according to the data in the untreated benign parotid tumour after this method in the Second Affiliated Hospital of Dalian Midical University,oral and maxillofacial surgery Department.Material and methods: Retrospectively collected the 65 patients with benign tumour of parotid gland who confirmed by paraffin section in the second Affiliated hospital of Dalian medical university of oral and maxillofacial surgery during June 2013 to December 2014.All the patients were treated by cylindrical parotidectomy.In the operation,no branch of facial nerve was dissected after lift the skin flab, according to the location of the tumour,,the incision is extended to 0.5-1.0cm peripheral that include the whole tissue that above of the tumour,which is like a cylindrical.Put the negative sictin drain(17 kPa, drainage tube 12#) far away from the exposure of the facial nerve and vascular.Let patients to avoid the excitant foods which test so peppery,acid or sweet.After 72-96 hours,removed the suction drain according to the flow.To removing the stitches where at the surgical region on sixth day after operation. To assess how long the operation can be take and the incidence of postoperative tumor recurrence, facial nerve paralysis, salivary fistula, Frey ’s syndrome and ear lobe numbness.Recults: 1.The average of the operation’s time is about 45min;2.No patient has permanent facial paralysis,the rate of temporary facial paralysis is 13.8%,involving marginal mandibular branch(9.2%),buccal branch(9.2%) and temporal branch(1.5%);3.One patient has Frey ’s syndrome and four patients has ear lobe numbness;4.In the 58 cases of suction drain, no patient has flap necrosis,subcutaneous effusion and infection, no facial paralysis and skin concave deformity has occurred by pressure except one appeared hematoma.The rate of salivary fistula is 10.3%.Conclusion: The cylindrical parotidectomy can ensure the integrality of facial nerve with no dissection of it. It has a high reputation of the facial nerve protection.It suit for the superficial and isthmus part of parotid gland in parotidectomy.To benign tumours of parotid that occurred in isthmus,it has narrowed the scope of operation to keep glands most functions and avoiding the complications.The suction drain(17 kPa, drainage tube12#) plays a good role in the precaution of salivary fistula with no affection of tissue function and facial beauty,the drainage tube in 12# can make a better effect in healing of the incision.