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目的:通过比较腮腺手术中不同的面神经解剖,探讨其各自临床应用的利弊,为临床术式选择提供参考。方法:选择腮腺浅叶良性肿瘤或病变患者65例,随机采用颧支、下颌缘支、颊支的逆行解剖法或主干顺行解剖法解剖面神经,切除肿瘤。术后7d,观察面瘫发生情况和评估面神经损伤程度,并随访6个月。结果:顺行解剖组(主干解剖组)术后面瘫发病率(13.3%)低于下颌缘支组(60.0%)、颧支组(46.2%)和颊支组(41.7%)。结论:在熟悉操作的前提下,采用面神经顺行解剖法可减少面瘫的发生。腮腺手术在面神经主干显露不受干扰的情况下,提倡采用顺行解剖法解剖面神经。
OBJECTIVE: To compare the pros and cons of different facial nerves in parotid gland surgery and to explore the pros and cons of their respective clinical applications, so as to provide a reference for the selection of clinical procedures. Methods: A total of 65 patients with benign tumor or lesion of parotid gland were selected. The facial nerve was dissected through the zygomatic branch, mandibular limbal branch, retrograde dissection of the buccal branch, or the anatomy of the main line. The tumors were excised. Seven days after operation, the occurrence of facial paralysis and the degree of facial nerve injury were observed and followed up for 6 months. Results: The incidence of facial paralysis in the antegrade anatomy group (13.3%) was lower than that in the mandibular marginal group (60.0%), zygomatic branch group (46.2%) and buccal branch group (41.7%). CONCLUSION: Facial paralysis can be used to reduce the incidence of facial paralysis when familiar with the operation. Parotid gland surgery in the facial nerve trunk revealed undisturbed circumstances, the use of anatomical anatomy of the anatomical facial nerve.