Min Hyun Jung, Lee Hyung Seok, Lee Yong Seop, Jeong Jin Hyeok, Cho Seok Hyun, Lee Seung Hwan, Kim Kyung Rae, Park Chul Won, Tae Kyung
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea.
Otolaryngol Head Neck Surg. 2007 Oct;137(4):636-41. doi: 10.1016/j.otohns.2007.05.061.
To evaluate the necessity of preserving the posterior branch of the great auricular nerve during parotidectomy.
Forty-six patients undergoing parotidectomy were prospectively analyzed. Twenty-four patients had preservation of the posterior branch of the great auricular nerve; in the remaining 22 patients the nerve was sacrificed. A sensory index score was defined as the area involved multiplied by the intensity grade of sensory loss. Quality-of-life was evaluated with a questionnaire.
The sensory index score was significantly higher in the sacrificed group as compared with the preserved group at both 1 week (41.87 vs 62.11) and 1 month (24.91 vs 46.11) after parotidectomy. The sensory deficit improved over time in both groups, and after 12 months only minimal sensory loss remained. Quality-of-life was not significantly different between the groups.
Irrespective of preservation of the posterior branch of the great auricular nerve, sensory deficit improved over time. Therefore, preservation of the posterior branch of the great auricular nerve might not be necessary during parotidectomy.
评估在腮腺切除术中保留耳大神经后支的必要性。
对46例行腮腺切除术的患者进行前瞻性分析。24例患者保留了耳大神经后支；其余22例患者牺牲了该神经。感觉指数评分定义为受累面积乘以感觉丧失的强度等级。采用问卷调查评估生活质量。
腮腺切除术后1周（41.87对62.11）和1个月（24.91对46.11）时，牺牲组的感觉指数评分显著高于保留组。两组的感觉缺陷均随时间改善，12个月后仅残留轻微感觉丧失。两组间生活质量无显著差异。
无论是否保留耳大神经后支，感觉缺陷均随时间改善。因此，在腮腺切除术中可能无需保留耳大神经后支。
