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目的通过与直接拉拢缝合比较,探讨带蒂胸锁乳突肌肌瓣修复腮腺肿瘤切除后缺损的疗效。方法回顾分析2002年1月-2010年4月,采用带蒂胸锁乳突肌肌瓣一期修复38例(肌瓣组)腮腺肿瘤切除后缺损患者的临床资料,与同期直接拉拢缝合修复的35例(对照组)患者进行比较。两组患者性别、年龄、病程、肿瘤类型及大小等一般资料比较,差异均无统计学意义(P<0.05),具有可比性。分析两组术后局部凹陷畸形、Frey综合征和腮腺瘘并发症发生情况。结果肌瓣组术后肌瓣均成活,创面Ⅰ期愈合;对照组切口均Ⅰ期愈合。术后两组患者均获随访,随访时间6～98个月。随访期间肿瘤均无复发。术后6个月两组患者面部凹陷畸形程度比较,差异有统计学意义(χ2=53.202,P=0.000)。肌瓣组术后发生1例(2.6%)腮腺瘘,1例(2.6%)Frey综合征;对照组分别为8例(22.8%)及20例(57.1%);两组并发症发生率比较差异均有统计学意义(P<0.05)。结论采用带蒂胸锁乳突肌肌瓣修复腮腺肿瘤切除后缺损,可预防术后局部凹陷畸形、Frey综合征和腮腺瘘并发症的发生。
Objective To compare the efficacy of pedicled sternocleidomastoid muscle flap in the repair of parotid gland tumor excision defect by comparing with the direct suture. Methods From January 2002 to April 2010, the clinical data of 38 cases (parotid glandular tumor group) with parotid tumor excision were retrospectively analyzed by using the pedicle of sternocleidomastoid muscle flap in the first phase. Compared with the direct suture repair 35 patients (control group) patients were compared. The two groups of patients with gender, age, duration, tumor type and size and other general information, the difference was not statistically significant (P <0.05), comparable. The postoperative complications of local deformity, Frey syndrome and parotid fistula were analyzed. Results The muscle flap survived in the flap group and the wound healed in the first stage. The wounds in the control group were healed in the first stage. All patients were followed up for 6 to 98 months. No recurrence of tumor during follow-up. There was significant difference in facial deformity between the two groups at 6 months after operation (χ2 = 53.202, P = 0.000). 1 case (2.6%) parotid fistula and 1 case (2.6%) Frey syndrome occurred in the flap group after operation. The control group were 8 cases (22.8%) and 20 cases (57.1%) respectively. The complication rates The differences were statistically significant (P <0.05). Conclusion The pedicle sternocleidomastoid muscle flap can be used to repair the defect after parotidectomy excision, which can prevent the occurrence of postoperative local depression deformity, Frey syndrome and parotid fistula.