Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Laryngoscope. 2010 Apr;120(4):724-30. doi: 10.1002/lary.20822.
OBJECTIVES/HYPOTHESIS: To determine the incidence of major and minor complications and their impact on patients' comfort after parotid surgery in benign disease.
Retrospective.
Four hundred ninety-two patients were included. Total parotidectomy (TP) was performed in 65.8%, superficial parotidectomy (SP) in 27.2%, and partial superficial parotidectomy (PSP) in 7.0%. Patients were interviewed using a self-designed questionnaire. Incidence of complications was evaluated depending on the extent of surgery and intensity of complaints. To ascertain the impact of morbidity on their daily lives, patients were asked to estimate it according to a visual analog scale.
Frey's syndrome occurred in 63.4%, and temporary facial nerve palsy in 32.7% of all cases. Both rates were significantly reduced after PSP. Permanent facial nerve paresis was observed in 2.3% of the cases, but in no case after PSP. Perception of patients and their scores reflected these results. Scores regarding Frey's syndrome and facial nerve paresis showed a significant positive correlation with extent of surgery. The recurrence rate was 2.2%; no recurrences were noted after PSP. Scores of perceived general condition indicated an excellent state.
The incidence of complications was reduced after PSP compared to SP or TP. Patient scores, which represent their perception of these complications, reflected these data and may be an additional instrument to measure outcome. These data suggest that less invasive operative techniques should be considered in case of a benign disease.
目的/假设:确定良性疾病患者腮腺手术后主要和次要并发症的发生率及其对患者舒适度的影响。
回顾性研究。
共纳入 492 例患者。行腮腺全切除术(TP)者占 65.8%,腮腺浅叶切除术(SP)者占 27.2%,腮腺部分浅叶切除术(PSP)者占 7.0%。采用自行设计的问卷对患者进行访谈。根据手术范围和投诉程度评估并发症的发生率。为了确定发病率对日常生活的影响,患者根据视觉模拟评分法(VAS)来估计其影响。
所有病例中 Frey 综合征发生率为 63.4%,暂时性面神经麻痹发生率为 32.7%。PSP 后这两种发生率均显著降低。永久性面神经瘫痪仅见于 2.3%的病例,但无一例发生于 PSP 后。患者的感知及其评分反映了这些结果。关于 Frey 综合征和面神经瘫痪的评分与手术范围呈显著正相关。复发率为 2.2%;PSP 后无复发。感知的一般状况评分表明状态极好。
与 SP 或 TP 相比,PSP 后并发症发生率降低。代表患者对这些并发症的感知的评分反映了这些数据,并且可能是衡量手术效果的附加工具。这些数据表明,对于良性疾病,应考虑采用侵袭性较小的手术技术。