Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Onco Targets Ther. 2013 Apr 10;6:361-7. doi: 10.2147/OTT.S43073. Print 2013.
Conventional radical neck dissection often causes a variety of complications. Although the dissection method has been improved by retaining some tissues to reduce complications, the incomplete dissection may cause recurrence of disease. In the present study, we developed a novel radical neck dissection, which preserves the external jugular vein, the greater auricular nerve, and the deep branches of the cervical nerve, to effectively reduce complications and subsequently, to promote the postoperative survival quality.
A total of 100 cases of radical neck dissection were retrospectively analyzed to evaluate the efficacy, rate of complication, and postoperative dysfunction of patients treated with the novel radical neck dissection. Data analysis was performed using the Chi-square test.
Compared with conventional radical neck dissection, the novel radical neck dissection could significantly reduce complications and promote postoperative survival quality. Particularly, the preservation of the external jugular vein reduced the surgical risk (ie, intracranial hypertension) and complications (eg, facial edema, dizziness, headache). Preservation of the deep branches of the cervical nerve and greater auricular nerve resulted in relatively ideal postoperative functions of the shoulders and ear skin sensory function (P < 0.05), while the two types of dissection procedures showed no differences in the recurrence rate (P > 0.05).
Our novel radical neck dissection procedure could effectively reduce the complications of intracranial hypertension, shoulder dysfunction, and ear sensory disturbances. It can be used as a regular surgical approach for oral carcinoma radical neck dissection.
传统的根治性颈清扫术常导致多种并发症。尽管通过保留一些组织来减少并发症,已经对其解剖方法进行了改进,但不完全的解剖可能导致疾病的复发。在本研究中,我们开发了一种新的根治性颈清扫术,保留颈外静脉、耳大神经和颈神经深支,以有效减少并发症,进而提高术后生存质量。
回顾性分析 100 例根治性颈清扫术患者的资料,评估采用新型根治性颈清扫术的患者的疗效、并发症发生率和术后功能障碍。采用卡方检验进行数据分析。
与传统根治性颈清扫术相比,新型根治性颈清扫术可显著降低并发症发生率,提高术后生存质量。特别是保留颈外静脉可降低手术风险(如颅内压升高)和并发症(如面部水肿、头晕、头痛)。保留颈神经深支和耳大神经可使肩部和耳部皮肤感觉功能的术后功能相对理想(P < 0.05),而两种手术方式的复发率无差异(P > 0.05)。
我们的新型根治性颈清扫术可有效减少颅内压升高、肩部功能障碍和耳部感觉障碍等并发症。它可以作为口腔癌根治性颈清扫术的常规手术方法。