Clinical Observation Of Functional Parotid Gland Surgery For Benign Tumors Of The Posterior Lower Pole Of The Parotid Gland

Objective In this study,a small incision was made around the mandibular angle to preserve the superficial muscular aponeurotic system(SMAS)and the dominant parotid gland tube for benign tumors with the diameter of the posterior inferior pole of the parotid gland less than 3cm.By observing the occurrence of postoperative complications and the preservation of the secretion function of the remaining glands,the clinical application value of this surgical method was discussed.Method From March 2018 to June 2019,21 patients with benign parotid tumors with posterior lower pole diameter less than 3cm admitted to the Oral and maxillofacial Surgery Department of The General Hospital of Ning Medical University were collected as the case group.Parotidectomy was performed with small incision around the mandibular Angle,parotid masseter fascia,great auricular nerve and parotid main duct.At the same time,23 patients with retroparotid benign tumors who underwent superficial parotid lobotomy were randomly selected as the control group from the previous archived medical records(From February 2017 to April 2018,at least half a year after surgery).In the form of questionnaire survey and outpatient appointment visit two groups of subjects were followed for treatment of postoperative temporary facial paralysis,the earlobe,and the area area skin numbness,Frey syndrome,and concealment of the scar area concave deformity happening,and compare the two groups of cases of postoperative residual parotid gland tissue of saliva,and compared the clinical effect of two kinds of operation ways.SPSS20.0statistical software was used for statistical analysis.Results A total of 44 parotid gland surgery patients were included,and the two groups were followed up for 6-32 months.In the case group,parotid regional resection was performed with a small incision around the mandibular Angle,and the parotid masseter fascia and the parotid dominant tube were retained.In the control group,superficial parotid lobectomy was performed with an "S" incision.The average operation time in the case group was(1.76±0.73)hours,while the average operation time in the control group was(2.12±0.38)hours,there was a significant difference between the two groups(P=0.042<0.05).The incidence of temporary facial paralysis was 19.04% in the case group and 52.17% in the control group,with statistically significant difference between the two groups(P=0.049<0.05).Postoperative scar visual simulation scale scores of the two groups the average score of the case group was(9.181±0.669),while the average score of the control group was(8.239±0.705),the difference between the two groups was statistically significant(P=0.000<0.05).In the satisfaction evaluation of the depression in the operative area,17 patients in the case group were satisfied,3 patients were relatively satisfied,1 patient was dissatisfied,and 10,8 and 5 patients in the control group were satisfied,relatively satisfied and dissatisfied,respectively,The difference between the two groups was statistically significant(P=0.000<0.05).There were statistically significant differences in subjective and objective evaluation of gustaturative sweating syndrome between the case group and the control group(subjective evaluation: P=0.036<0.05;Objective evaluation: P=0.022<0.05).The secreting function of the affected parotid gland was well preserved in the case group of 20 cases,while the secreting function of the affected parotid gland was lost in all the subjects in the control group.There was a significant statistical difference between the two groups(P=0.000<0.05).The incidence of numbness in earlobe and operative area was 23.81% in the case group and 30.43% in the control group,with no statistical difference(P=0.622>0.05).Therewas no statistically significant difference in the incidence of salivary leakage and the rate of tumor recurrence between the two groups(P>0.05),and the overall surgical effect of the case group was better than that of the control group.Conclusion 1.Benign tumors with the diameter of the posterior inferior pole of the parotid gland less than 3cm were treated with a small incision around the mandibular Angle,with sufficient exposure of the surgical field,simple operation,concealed scar in the surgical area,and good aesthetics.2.Regional parotid gland resection is performed in a shorter time with a lower incidence of overall complications,which can effectively preserve the secretion function of the remaining glands.3.The SMAS was retained,the parotid stump was sewed,and the parotid stump was closed up and sutured with the anterior one-third of the sternocleidomastoid and the posterior belly of the digastric muscle to form a barrier,reduce the incidence of Frey syndrome,improve the depression deformity in the surgical area,and better restore the facial contour.