Witt Robert Lee
Department of Surgery, Christiana Care Health Center, Wilmington, DE 19806, USA.
J Voice. 2006 Sep;20(3):461-5. doi: 10.1016/j.jvoice.2005.06.001. Epub 2005 Oct 19.
The long-term recovery rate of immediate postoperative facial nerve dysfunction with an electrophysiologically and anatomically intact facial nerve is higher than the long-term recovery rate of immediate postoperative vocal fold immobility with an electrophysiologically and anatomically intact recurrent laryngeal nerve.
A retrospective review of parotid and thyroid surgery with electrophysiologic monitoring of the facial and recurrent laryngeal nerves, respectively.
Forty-five consecutive patients had electrophysiologic and anatomic integrity of the facial nerve at the conclusion of the parotidectomy. Eight of 45 (18%) patients developed a postoperative facial nerve dysfunction. All eight patients with facial nerve dysfunction had complete return of facial nerve function within 3 months. A total of 102 consecutive patients underwent dissection of the recurrent laryngeal nerve during thyroid surgery. Seven of 102 (7%) had immediate unilateral vocal fold dysfunction. All 102 had electrophysiologic and anatomic integrity of the recurrent laryngeal nerve at the conclusion of the procedure. Two of 102 (2%) have clinically complete permanent vocal fold dysfunction. Five of seven (71%) with immediate complete vocal fold immobility had complete return of mobility.
A higher immediate postoperative rate of transient facial nerve dysfunction is reported compared with vocal fold immobility in parotid and thyroid surgery, respectively (P < 0.05). Immediate postoperative facial nerve dysfunction with an electrophysiologically response at 1 mA and an anatomically intact facial nerve during parotid surgery resulted in a complete return of function in all cases in this series. Immediate postoperative vocal fold immobility with an electrophysiological response at 1 mA and an anatomically intact recurrent laryngeal nerve had a 30% rate of being permanent in this series.
术后即刻面神经功能障碍且面神经在电生理和解剖结构上完整的长期恢复率高于术后即刻声带麻痹且喉返神经在电生理和解剖结构上完整的长期恢复率。
分别对腮腺手术和甲状腺手术进行回顾性研究，并对面神经和喉返神经进行电生理监测。
45例腮腺切除术后面神经在电生理和解剖结构上保持完整。45例患者中有8例（18%）出现术后面神经功能障碍。所有8例面神经功能障碍患者在3个月内面神经功能均完全恢复。共有102例连续患者在甲状腺手术中接受了喉返神经解剖。102例中有7例（7%）出现即刻单侧声带功能障碍。所有102例患者在手术结束时喉返神经在电生理和解剖结构上均保持完整。102例中有2例（2%）出现临床完全永久性声带功能障碍。7例即刻完全性声带麻痹患者中有5例（71%）声带活动完全恢复。
在腮腺手术和甲状腺手术中，分别报告术后即刻面神经功能障碍的发生率高于声带麻痹（P<0.05）。在本系列中，腮腺手术中术后即刻面神经功能障碍且在1mA时有电生理反应、面神经解剖结构完整，所有病例的功能均完全恢复。在本系列中，术后即刻声带麻痹且在1mA时有电生理反应、喉返神经解剖结构完整，永久性发生率为30%。
