Miloro Michael, Stoner Julie A
Oral and Maxillofacial Surgery, University of Nebraska Medical Center, Omaha, NE 68198-5180, USA.
J Oral Maxillofac Surg. 2005 Aug;63(8):1150-4. doi: 10.1016/j.joms.2005.04.031.
The goal of this study was to assess subjective patient recovery of donor site sensory deficit following sural nerve harvest for trigeminal nerve repair surgery.
A review of 42 consecutive sural nerve graft patient records yielded 26 patients, at least 20 months following sural nerve grafting for trigeminal nerve repair, who participated in a telephone questionnaire survey to assess subjective outcomes. The association between donor site outcome and other factors, including nerve graft recovery, age, gender, pain, cold sensitivity, scar cosmesis and tactile sensitivity, and legal involvement were analyzed, and presurgical and present levels of donor and nerve graft site sensibility were compared.
The perceived area of donor site sensory deficit decreased significantly over time. Postoperative donor site pain and cold sensitivity at low levels were reported by few patients, and the majority have completely resolved. Most patients reported no problems with scar cosmesis or pain. There was a moderate agreement between donor site recovery and nerve graft recovery (kappa = 0.32). Few patients reported satisfaction with one site and not the other or complete dissatisfaction with both sites. Other factors such as age, gender, or legal involvement were not found to correlate with satisfaction level.
The use of a questionnaire for subjective assessment of neurosensory recovery following nerve graft repair yields outcomes information that is generally not considered in the traditional clinical patient assessment. The majority of patients tolerate sural nerve harvest without significant donor site morbidity.
本研究的目的是评估在为三叉神经修复手术采集腓肠神经后供区感觉功能缺损的患者主观恢复情况。
回顾42例连续的腓肠神经移植患者记录,筛选出26例在接受三叉神经修复的腓肠神经移植术后至少20个月的患者,他们参与了一项电话问卷调查以评估主观结果。分析了供区结果与其他因素之间的关联,这些因素包括神经移植恢复情况、年龄、性别、疼痛、冷敏感、瘢痕美观度和触觉敏感性以及法律纠纷情况,并比较了术前和当前供区及神经移植部位的感觉水平。
供区感觉功能缺损的感知面积随时间显著减小。少数患者报告术后供区有轻度疼痛和冷敏感,且大多数已完全缓解。大多数患者报告瘢痕美观度或疼痛方面没有问题。供区恢复与神经移植恢复之间存在中度一致性(kappa = 0.32)。很少有患者报告对一个部位满意而对另一个部位不满意或对两个部位都完全不满意。未发现年龄、性别或法律纠纷等其他因素与满意度相关。
使用问卷对神经移植修复后的神经感觉恢复进行主观评估可得出传统临床患者评估中通常未考虑的结果信息。大多数患者能够耐受腓肠神经采集,且供区无明显并发症。