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在腮腺手术中常觉掣肘者为面神经,多数腮腺手术实为这一神经的解剖术。50年前保存这一神经的方法为等待肿瘤达到一定体积,然后进行囊内解剖。25年以前,常建议找出其周围支(常为下颌支),然后向中央分离至神经干。近年则多从茎乳孔早期暴露其主干。作者提出以下手术步骤较切合实用。 1.手术时病人头部稍高于心脏以减少静脉出血,不需结扎颈外动脉。应使下颁闭合。 2.暴露半面部,以便观察前额、眼、鼻唇及颏部微小抽搐的出现。 3.作“Y”形切口,向前翻转皮瓣盖于腮
In the parotid gland surgery often feel that the facial nerve, the majority of parotid surgery is the anatomy of the nerve. 50 years ago to save this nerve is waiting for the tumor to reach a certain volume, and then intracapsular dissection. 25 years ago, it is often recommended to find the surrounding branch (often mandibular branch), and then to the central nerve trunk. In recent years, mostly from the early exposure of stem trichomes trunk. The authors suggest the following surgical procedures are more practical. 1. Surgery, the patient’s head slightly higher than the heart to reduce venous bleeding, no need to ligature the external carotid artery. Should make the next closed. 2. Expose the half face to observe the appearance of slight convulsions in the forehead, eyes, nose, and chin. 3. For “Y” shaped incision, flip the flap forward in the cheek