Clinical And Experiment Research Of The Application Of Improved Surgical Procedure For Treating Pleomorphic Adenoma Of Parotid Gland

Objective To explore improvement methods not only can effectively eradicate a tumor, but alao can keep patients maximum facial form is beautiful, and physiological function of parotid glands, prevention of Frey syndrome and concave facial deformity after parotidectomy.Methods Through the case control studies, combined with pathology, immunohistochemical (The occurrence rates of tumor recurrence, facial nerve paralysis, salivary fistula, Frey’s syndrome, anaesthesia of auricular region and shape of the face were compared by different operation way.) and Meta analysis.Results The incidence of tumor recurrence, the facial paralysis and sialosyrinx were no significant difference between two groups. Frey’s syndrome, the naesthesia of auricular region, and facial asymmetry in functional parotidectomy group were much lower than conventional group (all P<0.05). The depth of infiltration were no significant difference between two groups. Tumor smaller than2cm:the depth of infiltration in conventional group was from0.061to1.122mm, functional group was from0.442 to3.127mm (Z=1.785, P=0.074); tumors between2-4cm:the depth in conventional group was from0.081to7.908mm, functional group is from0.082mm to6.632mm (Z=-0.011, P=0.911). Meta-analysis for surgical techniques and the application of sternocleidomastoideus muscle flap can prevent symptomatic Frey syndrome, positive starch-iodine test results, The application of acellular dermal matrix decreased the incidence rates of symptomatic Frey syndrome and positive starch-iodine test, but did not decrease the incidence rates of contour deformity.Conclusions Compare with conventional operation group, functional parotidectomy has less complications. It is of valuable in clinical application. The surgical margins of pleomorphic adenomas of the parotid gland shoud be classified by the size of tumor. The surgical margins for all the tumors which are small than4cm are10mm, and the larger than4cm shoud use superficial parotidectomy. Meta-analysis of operative techniques to prevent symptomatic Frey syndrome, positive starchiodine test results, and facial asymmetry suggests that such methods are likely to reduce the incidence of these complications and improve the quality of life after parotidectomy...