Guntinas-Lichius Orlando, Straesser Arianna, Streppel Michael
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Koeln, Germany.
Laryngoscope. 2007 Mar;117(3):421-6. doi: 10.1097/MLG.0b013e31802d83df.
Analyze the postoperative quality of life (QoL) in patients after surgical nerve repair for facial nerve lesion.
Descriptive study using questionnaire data and medical chart review.
Forty-nine patients answered the Short Form-36 (SF-36), the European Organization for Research and Treatment (EORTC) questionnaires QLQ-C30 and QLQ-HN35, and a modification of the Acoustic Neuroma Hospital of Norway Survey. Facial function was self-evaluated by the patients using the House-Brackmann (HB) scale and the Stennert index (SI). The questionnaire data were analyzed in relation to the medical chart data.
The follow-up time ranged from 12 to 202 months. The underlying disease was benign in 34 (61%) patients and malignant in 15 (39%) patients. Facial nerve repair was successful in all patients, with a mean HB scale of 3.1, a mean SI of 4.9, and a mean May grading of 2.7. The facial function self-evaluation was not significantly different. Seventy-five percent of the patients were satisfied with the operation. The SF-36 demonstrated a significantly lower social functioning, emotional role, general mental health, and vitality lower than in the normal German population. In the EORTC QLQ C30, emotional function was low and the insomnia rate high. EORTC QLQ HN35 showed a high rate of trouble with social eating, less sexuality, problems opening mouth, and weight gain problems. Age 45 years or older, female sex, May grading 3 or greater, SI self-assessment 5 or greater, HB self-assessment greater than 2 had a significant negative effect on some QoL items, but not factors such as type or histology of the disease or delayed reconstruction.
Although grading of facial function after nerve repair revealed satisfying results, the patients experience a reduced QoL.
分析面神经损伤手术修复患者术后的生活质量（QoL）。
采用问卷调查数据和病历回顾的描述性研究。
49名患者回答了简明健康状况调查量表（SF-36）、欧洲癌症研究与治疗组织（EORTC）问卷QLQ-C30和QLQ-HN35，以及挪威神经瘤医院调查问卷的一个修改版本。患者使用House-Brackmann（HB）量表和施泰纳特指数（SI）对面部功能进行自我评估。问卷数据与病历数据相关联进行分析。
随访时间为12至202个月。34名（61%）患者的基础疾病为良性，15名（39%）患者为恶性。所有患者面神经修复均成功，平均HB量表评分为3.1，平均SI为4.9，平均梅氏分级为2.7。面部功能自我评估无显著差异。75%的患者对手术满意。SF-36显示社会功能、情感角色、总体心理健康和活力显著低于正常德国人群。在EORTC QLQ C30中，情感功能较低，失眠率较高。EORTC QLQ HN35显示社交进食困难、性功能减退、张口问题和体重增加问题发生率较高。45岁及以上、女性、梅氏分级3级或更高、SI自我评估5级或更高、HB自我评估大于2对某些生活质量项目有显著负面影响，但对疾病类型或组织学或延迟重建等因素无影响。
尽管神经修复后面部功能分级显示出令人满意的结果，但患者的生活质量有所下降。
