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目的:探讨腮腺咬肌筋膜和脱细胞异体真皮基质(ADM)用于腮腺手术后味觉出汗综合征的效果。方法:2005.1～2007.12.收治腮腺良性肿瘤患者58例,随机分为4组:①对照组(A组)15例,单纯行不保留咬肌筋膜的腮腺浅叶或部分浅叶切除术;②保留咬肌筋膜组(B组)15例,在腮腺浅叶或部分浅叶切除术中保留腮腺咬肌筋膜;③ADM组(C组)12例,行不保留咬肌筋膜的腮腺浅叶或部分浅叶切除术后,根据缺损大小植入脱细胞异体真皮;④ADM+保留咬肌筋膜组(D组)16例,在腮腺浅叶或部分浅叶切除术中保留腮腺咬肌筋膜,并根据缺损大小植入脱细胞异体真皮。所有病例术后随访,进行临床检查及碘-淀粉试验。结果:A组12/15例(80.0%)、B组2/15例(13.33%)、C组2/12例(16.67%)、D组1/16例(1.32%)出现味觉出汗综合征(碘淀粉试验阳性),D组和B、C组比较,统计学有显著差异(P<0.05)。结论:在腮腺浅叶或部分浅叶切除术中保留腮腺咬肌筋膜,并根据缺损大小植入脱细胞异体真皮能明显减小味觉出汗综合征的发生率。
Objective: To investigate the effect of parotid masseterial fasciae and acellular allograft dermal matrix (ADM) on taste-induced sweating syndrome after parotid surgery. Methods: 58 patients with parotid benign tumors were randomly divided into 4 groups: 1 in the control group (group A), 15 patients who underwent the parotid superficial lobe or part of the superficial lobectomy without retention of the masseter fascia. 2 Methods: 2005.1-2007.12. The masseter fasciae group (Group B) was preserved in 15 cases and the parotid masseter fascia was retained in the parotid gland or some of the superficial lobectomy; the 3ADM group (C) was in 12 cases and the parotid glands that did not retain the masseter fascia were preserved. After lobectomy or partial lobar resection, acellular allografts were implanted according to the size of the defect; 4 ADMs were retained in the masseter fasciae group (group D). 16 retained the parotid masseters fascia in the parotid gland or some of the superficial lobes. , And according to the size of the defect implantation of acellular allogeneic dermis. All patients were followed up for clinical examination and iodine-starch test. RESULTS: Taste-sweating synthesis occurred in 12/15 cases (80.0%) in group A, 2/15 cases (13.33%) in group B, 2/12 cases (16.67%) in group C, and 1.36% in group D (1.32%). Signs (positive iodine starch test), D group and B, C group, statistically significant differences (P <0.05). CONCLUSION: The retention of the parotid masseter fascia in the superficial or partial superficial lobe of the parotid gland and the implantation of acellular allografts based on the size of the defect can significantly reduce the incidence of taste-induced sweating syndrome.