Patel N, Har-El G, Rosenfeld R
Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, 340 Henry St, Brooklyn, NY 11201, USA.
Arch Otolaryngol Head Neck Surg. 2001 Jul;127(7):884-8.
To determine the impact of great auricular nerve (GAN) sacrifice during parotidectomy on patients' quality of life.
Historical cohort survey of patients who had undergone GAN sacrifice during parotidectomy.
Tertiary academic otolaryngologic practice.
Fifty-three patients who had undergone GAN sacrifice during parotidectomy completed an 8-item quality-of-life survey with a 7-point response scale designed to measure outcome after GAN sacrifice during parotidectomy.
Thirty patients (57%) reported experiencing at least 1 abnormal symptom, but the mean number of symptoms decreased significantly with time, from a mean of 2.3 during the first year to 0.2 after 5 years (P<.001). Even among patients experiencing symptoms, 23 (77%) reported only a little or no bother caused by the symptoms, and 27 (90%) reported no interference or almost none with their daily activities. The degree of bother or interference reported had a moderate positive correlation with the number of abnormal sensations reported.
The results suggest that, while many patients experienced sensory deficits, the overall quality of life was not significantly affected after GAN sacrifice during parotidectomy. Patients who report multiple abnormal sensations, however, would benefit from additional counseling and from reassurance that the number of sensations will diminish with time. Further study evaluating the effect of preservation of the posterior branch of the GAN during parotidectomy on patients' quality of life is needed.
确定腮腺切除术中牺牲耳大神经(GAN)对患者生活质量的影响。
对在腮腺切除术中牺牲GAN的患者进行历史性队列研究。
三级学术性耳鼻喉科医疗机构。
53例在腮腺切除术中牺牲GAN的患者完成了一项包含8个项目的生活质量调查,该调查采用7分制反应量表,旨在衡量腮腺切除术中牺牲GAN后的结果。
30例患者(57%)报告至少出现1种异常症状,但症状的平均数量随时间显著减少,从第一年的平均2.3种降至5年后的0.2种(P<0.001)。即使在出现症状的患者中,23例(77%)报告症状造成的困扰很小或没有困扰,27例(90%)报告症状对其日常活动没有干扰或几乎没有干扰。报告的困扰或干扰程度与报告的异常感觉数量呈中度正相关。
结果表明,虽然许多患者出现了感觉缺陷,但腮腺切除术中牺牲GAN后总体生活质量并未受到显著影响。然而,报告有多种异常感觉的患者将受益于额外的咨询以及关于这些感觉数量会随时间减少的 reassurance。需要进一步研究评估腮腺切除术中保留GAN后支对患者生活质量的影响。