耳下腺上皮性腫瘍手術症例の検討

Clinical study of parotid epithelial tumors：a statistical analysis of two decades

Ⅰ．はじめに

　耳下腺腫瘍は頭頸部腫瘍の約4％^1）であるが，近年増加傾向が指摘されている^2）。われわれは以前に1987～1996年の耳下腺上皮性腫瘍手術138例の検討を行い，種々の問題点を指摘した^3）。その後10年が経過し，同数以上の手術を行った。この間当科では治療に携わった医師が交替し，かつ国内外の手術術式や顔面神経の取り扱いに関する議論^4～7）に従って，術式も若干変更した。そこで，以前の10年間の症例と合わせ，20年間に手術を実施した耳下腺腫瘍の検討を行い，その臨床像の変遷を明らかにしようと考えた。また，術式変更による術後顔面神経麻痺についても検討した。

　From 1987 to 2006,352 cases underwent excisions of epithelial tumors of the parotid gland（298 benign and 54 malignant）in the Department of Otolaryngology,Head and Neck Surgery of Nippon Medical School. Incidence,age,gender,pathological diagnosis,and facial palsy were studied. Among pleomorphic adenomas,Warthin tumors,and carcinomas,the incidence of Warthin tumors in the years from 1997 to 2006 was remarkably higher than that of in the years from 1987 to 1996. Although the average age of patients with pleomorphic adenomas and carcinomas at the surgery in the later decade was increased,that of those with Warthin tumors was decreased. Although incidence of facial palsy after surgery of benign tumors in the previous decade was 36.4％,that of later decade was 12.2％. The incidence was statistically lower in the later decade. These results suggested that changes of clinical features were observed in our department during 20 years.