In primary therapy, a universally recognized surgical indication applies to all tumors of the salivary glands. According to the classic rule, radical resection of a head and neck tumor requires clean margins of at least 5 mm, although recent studies have shown that for certain locations, 1 mm may be sufficient. In the surgical resection of a tumor of the salivary glands, especially of the parotid gland, can these rules be respected? Owing to the complex branching and connections of the facial nerve within the parotid gland, even a medium-sized malignant tumor may be in contact with a branch of the nerve, thus raising the question of its preservation. The facial nerve is so important from a functional and aesthetic point of view that it is commonly believed that it should be preserved unless it is incorporated into the tumor. This is a compromise between an oncological resection, that is, the complete excision of the tumor with no residual cancer cells left behind, and quality of life. Almost all authors try to overcome this lack of radicality by indicating postoperative (chemo)radiotherapy. In this article, the pros and cons of nerve preservation will be analyzed by examining the published studies on this topic.
在原发性治疗中，唾液腺肿瘤存在普遍认可的手术指征。根据经典原则，头颈部肿瘤的根治性切除需要至少5毫米的阴性切缘，尽管近期研究表明对于特定部位，1毫米切缘可能已足够。在唾液腺（尤其是腮腺）肿瘤的手术切除中，这些原则能否得到遵循？由于面神经在腮腺内存在复杂的分支与连接，即使是中等大小的恶性肿瘤也可能与神经分支接触，从而引发神经保留的问题。从功能和美观角度来看，面神经至关重要，因此普遍认为除非神经已被肿瘤侵犯，否则应予以保留。这是在肿瘤学切除（即完全切除肿瘤且不残留癌细胞）与生活质量之间的一种折衷方案。几乎所有学者都试图通过术后（化学）放疗来弥补这种根治性的不足。本文将通过对该主题已发表研究的分析，探讨神经保留的利弊。
Radical Resection of Malignant Tumors of Major Salivary Glands: Is This Possible?
肿瘤(癌症)患者之家