耳下腺深葉の良性多形腺腫の外科的治療法

Surgical Treatment of Benign Pleomorphic Adenoma in the Deep Lobe of the Parotid Gland

　はじめに

　耳下腺浅葉の多形腺腫の手術治療は耳下腺浅葉切除術または浅葉部分切除術が原則で，腫瘍核出術は禁忌とされてきた。しかし，腫瘍と顔面神経とが接している症例の浅葉切除術は，顔面神経処理の問題で腫瘍全周に正常組織をつけて摘出することが困難なこともある。一方，深葉原発例は腫瘍と顔面神経が接している症例が多く，深葉部分切除術か腫瘍核出術が行われることが多い。われわれは開院以来18年間の耳下腺深葉の良性多形腺腫症例を対象に腫瘍と顔面神経との関係，手術方法，術後の再発などを検討し，深葉の多形腺腫の外科的治療法について若干の文献的考察を加え報告する。

For the last 18 years, 23 patients with a benign Pleomorphic adenoma in the deep lobe of the par-otid gland, including 19 primary and 4 recurrent cases, underwent surgical treatment in our Univer-sity Hospital.

Females were frequently affected by the deep lobe than males in the patients under 50 years old, but the sex distribution was equal in both sexes in those over 50 years old.

Enucleation of adenoma was performed in 17 patients and partial lobectomy of the deep lobe in 6 patients. No recurrence was found in the primary adenoma cases. Enucleation with the entire capsule of the adenoma or partial resection of the deep lobe with preservation of the facial nerve are treatment of choice for surgery of pleomorphic adenoma of the deep lobe of the parotid gland.