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良性腮腺疾病手术后发生面瘫的预测因素:626 例手术的多变量分析。

Predictors of facial palsy after surgery for benign parotid disease: multivariate analysis of 626 operations.

机构信息

Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Head Neck. 2009 Dec;31(12):1588-92. doi: 10.1002/hed.21134.

Abstract

BACKGROUND

The objective was to identify the risk factors for, and incidence of, facial palsy following conservative parotidectomy.

METHODS

Conservative parotidectomies for benign diseases (N = 626) were studied retrospectively. The risk factors for postoperative facial palsy were determined by univariate and multivariate analyses of variables related to patient demographics, comorbid illnesses, and characteristics of the operation.

RESULTS

The rate of transient facial palsies was 23.16% following parotidectomy. Significant risk factors for transient facial palsy were diabetic mellitus (odds ratio [OR] 1.727 [95% CI: 1.062-2.810]) and extended surgery (OR 3.049 [95% CI: 2.058-4.515]). Only the type of surgery was found to have a statistically significant causal relation with permanent facial palsy (p = .017).

CONCLUSIONS

Comorbid diabetes, and more extensive as opposed to partial superficial parotidectomy, may be associated with transient facial palsy following operation for benign parotid disease. The incidence of permanent facial palsy may be higher when a more extensive parotidectomy is performed.

摘要

背景

本研究旨在确定行保守性腮腺切除术后面瘫的风险因素及发病率。

方法

回顾性分析了 626 例因良性疾病而行保守性腮腺切除术患者的临床资料。通过单因素和多因素分析,确定与患者人口统计学特征、合并症及手术特征相关的变量与术后发生面瘫的关系。

结果

腮腺切除术后暂时性面瘫的发生率为 23.16%。糖尿病(优势比 [OR] 1.727 [95%可信区间:1.062-2.810])和广泛手术(OR 3.049 [95%可信区间:2.058-4.515])是暂时性面瘫的显著危险因素。仅手术类型与永久性面瘫有统计学显著的因果关系(p =.017)。

结论

对于良性腮腺疾病,合并糖尿病和相对于部分腮腺浅叶切除术而言的广泛手术可能与术后暂时性面瘫有关。当进行更广泛的腮腺切除术时,永久性面瘫的发生率可能更高。

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