| Objective: To retrospectively analyze the clinical and follow-up data of superficial parotid benign tumor in the Department of Oral and Maxillofacial surgery of Yijishan Hospital,the first affiliated Hospital of Southern Anhui Medical College,and to explore the correlation between the postoperative complications and various factors during and after operation.in order to guide clinical treatment and prevention.Methods: The medical records of 111 patients with superficial lobe benign tumor of parotid gland who were admitted to the Department of Oral and Maxillofacial surgery of Yijishan Hospital of the first affiliated Hospital of Southern Anhui Medical College from August 2018 to July 2020 were collected.The complications such as facial paralysis,Frey syndrome,salivary fistula,recurrence and earlobe numbness were collected through follow-up.The general data,the factors during and after operation and the occurrence of postoperative complications were analyzed.SPSS26.0 statistical software was used for data analysis.Results: Among the 111 patients with superficial lobe benign tumor of parotid gland,78(70.3%)were pleomorphic adenoma,23(20.7%)were Warthin’s tumor,and 10(9.0%)were basal cell adenoma.Among them,57(51.4%)were males and 54(48.6%)were females.The average age was 47.15 ±15.631 years old(age ranges from 11 to 80 years old);the average diameter of tumor was 2.130 ±0.7549 cm(diameter ranges from0.5 to 4.5 cm).The average operation time was 60(50～80)min(operation time ranges from 25 to 235 min),the average intraoperative blood loss was 20(10～20)ml(intraoperative blood loss ranges from 3 to 60 ml),and the average incision length was6(5～8)cm(incision length ranges from 2 to 12 cm).There was no significant difference in age between male and female patients(P > 0.05),but the tumor diameter of male patients was larger than that of female patients,and the difference was statistically significant(P < 0.05).There was no significant linear correlation between tumor diameter and patient age(P > 0.05).The postoperative complications were facial paralysis(20.7%),salivary fistula(9.1%),Frey syndrome(2.7%),recurrence(0%),decreased parotid secretion(15.3%)and earlobe numbness(43.9%).The incidence of facial paralysis,Frey syndrome and earlobe numbness in SP group was significantly higher than that in PSP group(P < 0.05),while the parotid secretion function in SP group was significantly lower than that in PSP group(P < 0.05),but there was no significant difference in the occurrence of salivary fistula between the two groups(P >0.05).Facial paralysis occurred in 23 cases after operation.After follow-up for half a year,the symptoms of facial paralysis were all improved.The symptoms of salivary fistula occurred in 10 cases after operation,and the symptoms of salivary fistula disappeared after 1-2 weeks of cross bandage compression.The periauricular sensation was abnormal in 27 patients after operation.After follow-up for more than half a year,the symptoms were significantly improved.The average follow-up time was 1 year(the range of follow-up time was 0.5 ～ 2 years).There were no recurrent symptoms in both groups.The incidence of salivary fistula in S-shaped incision group was significantly lower than that in modified incision group(P < 0.05).The incidence of facial paralysis in S-shaped incision group was significantly higher than that in modified incision group(P < 0.05).The incidence of facial paralysis in tumor diameter ≥ 2cm group was significantly higher than that in tumor diameter < 2cm group(P < 0.05).The incidence of facial paralysis in the antegrade facial nerve anatomy group was significantly lower than that in the retrograde group(P < 0.05).Further Logistic regression analysis showed that the risk of facial paralysis in SP group was 14.622 times higher than that in PSP group(P < 0.05).The risk of facial paralysis in S incision group was 13.178 times higher than that in modified incision group(P < 0.05).Large tumor diameter(OR=32.166)was a risk factor for facial paralysis(P < 0.05).The risk of salivary fistula in the modified incision group was 10.761 times higher than that in the S-shaped incision group(P < 0.05).The risk of developing Frey syndrome in SP group was16.000 times higher than that in PSP group(P < 0.05).The risk of periauricular numbness in SP group was 3.850 times higher than that in PSP group(P < 0.05).Conclusion: In the operation of benign tumor of superficial lobe of parotid gland,it is suggested that surgeons should reduce the scope of operation as much as possible,dissect the facial nerve(trunk method),carefully dissect the great auricular nerve,preserve the parotid masseter fascia and preserve the parotid duct as far as possible.during the operation,the stump of the gland was closely sutured,and the bandage was bandaged with pressure after operation,while negative pressure drainage was performed at the same time.This study proved that the above methods can reduce postoperative complications in the affected area,thus improving the quality of life of patients. |
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