To investigate the safety and feasibility of gasless total endoscopic resection of deep lobe parotid gland tumors via a postauricular hairline plus temporal approach. The approach was designed as: a 4 to 5 cm main incision was designed at the postauricular hairline, and a 0.5 cm auxiliary incision was designed in the temporal hairline. The operating cavity was established with the assistance of a special retractor. "Anterograde" dissection of the facial nerve was performed throughout the procedure, along with partial or total gland removal of the tumor. All 16 operations were successfully completed without conversion to open surgery. During the operation, the trunk and branches of the facial nerve were completely preserved, the tumor was completely removed, and the incision healed. Six patients had mild facial paralysis after operation, and recovered completely after 3 to 6 months. There was no salivary fistula, Frey syndrome, infection, or other complications. The postoperative incision was concealed and the aesthetic effect was good. The postauricular hairline plus temporal approach gasless total endoscopic parotidectomy is safe and feasible. This technique can achieve the complete dissection of the total trunk to the branches of the facial nerve, and has good access to the tumors located in any part of the parotid gland region. On the basis of radical resection of the tumor, it achieves minimally invasive and aesthetic improvement.
为探讨耳后发际加颞部小切口入路免充气完全内镜下腮腺深叶肿瘤切除的安全性和可行性，本研究纳入2021年4月至2022年9月就诊于四川大学华西口腔医院头颈肿瘤外科，采用耳后发际加颞部小切口入路免充气完全内镜下完成的腮腺深叶肿瘤切除病例16例。在患者耳后发际处设计4~5 cm主切口，颞部发际内设计0.5 cm的辅助切口，在专用建腔拉钩的辅助下建立操作腔。全程在内镜下行面神经“顺行”解剖，连同部分或全部腺体切除肿瘤。16例患者手术均顺利完成，无中转开放。术中面神经主干及分支均获得完整保留，肿瘤获得完全切除，切口甲级愈合。术后6例出现轻度面神经麻痹症状，术后3~6个月完全恢复。无涎瘘、Frey综合征、感染等其他并发症。术后切口隐蔽，美观效果良好。临床疗效表明，耳后发际加颞部小切口入路免充气完全内镜下可完成腮腺深叶肿瘤的切除，并且安全可行；该技术可实现面神经总干至分支的全程解剖，对位于腮腺区任何部位的肿瘤均有较好的可及性，在肿瘤根治的基础上实现了微创和美观的提升。.