Liu Dong Yan, Tian Xiao Jiao, Li Cheng, Sun Shao Shan, Xiong Ying Hui, Zeng Xian-Tao
Departments of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000;
Oncol Lett. 2013 Apr;5(4):1335-1342. doi: 10.3892/ol.2013.1179. Epub 2013 Feb 5.
Approximately 34-86% of neoplasms of the salivary glands are located in the parotid gland and parotidectomy is the first-line treatment for parotid gland tumors. Frey syndrome and cosmetic deformity are common complications experienced by patients following parotidectomy and the sternocleidomastoid muscle flap (SCMF) is used to prevent them. Numerous studies have been performed to examine the effectiveness of the SCMF for the prevention of cosmetic deformity and Frey syndrome, however, they provide contradictory results and possess small sample sizes with consequently low statistical power. In order to evaluate the effectiveness of the SCMF for the prevention of Frey syndrome and cosmetic deformity following parotidectomy, we performed a systematic review and meta-analysis based on published randomized controlled trials (RCTs), which were identified using PubMed and CNKI databases, and references of studies up to August 2012 were included. Using these criteria, we yielded 11 RCTs. Following an independent assessment of the methodological quality of these studies and the extraction of data, a systematic review and meta-analysis was conducted. The results of the meta-analysis demonstrated that there was a significant trend towards a lower risk of objective incidence [67%; risk ratio (RR), 0.33; 95% confidence interval (CI), 0.16-0.67; P<0.01] and subjective incidence (66%; RR, 0.34; 95% CI, 0.16-0.75; P= 0.01) of Frey syndrome in the SCMF group. The sensitivity analysis also indicated that this result was significant. Due to the considerable variation between the included studies, a meta-analysis was not applicable to assess cosmetic deformity. Two RCTs demonstrated that the difference between the SCMF and no SCMF group was not statistically significant, while the other seven RCTs detected a statistically significant difference between the two groups. Publication bias was detected. In conclusion, based on currently available evidence, the use of the SCMF is benefical for the prevention of Frey syndrome, however, whether it is also benefical for cosmetic deformity remains inconclusive.
约34%-86%的涎腺肿瘤位于腮腺，腮腺切除术是腮腺肿瘤的一线治疗方法。味觉出汗综合征和美容畸形是腮腺切除术后患者常见的并发症，胸锁乳突肌瓣（SCMF）用于预防这些并发症。已经进行了大量研究来检验SCMF预防美容畸形和味觉出汗综合征的有效性，然而，这些研究结果相互矛盾，且样本量小，因此统计效力低。为了评估SCMF预防腮腺切除术后味觉出汗综合征和美容畸形的有效性，我们基于已发表的随机对照试验（RCT）进行了系统评价和荟萃分析，这些试验通过PubMed和中国知网数据库进行识别，并纳入截至2012年8月的研究参考文献。根据这些标准，我们获得了11项RCT。在对这些研究的方法学质量进行独立评估并提取数据后，进行了系统评价和荟萃分析。荟萃分析结果表明，SCMF组味觉出汗综合征的客观发生率[67%；风险比（RR），0.33；95%置信区间（CI），0.16-0.67；P<0.01]和主观发生率（66%；RR，0.34；95%CI，0.16-0.75；P=0.01）有显著降低趋势。敏感性分析也表明该结果具有显著性。由于纳入研究之间存在较大差异，荟萃分析不适用于评估美容畸形。两项RCT表明，SCMF组和无SCMF组之间的差异无统计学意义，而其他七项RCT检测到两组之间存在统计学显著差异。检测到发表偏倚。总之，基于目前可得的证据，使用SCMF有利于预防味觉出汗综合征，然而，其对美容畸形是否有益仍无定论。
