Wang Wei, Fan Jin-chuan, Sun Chang-jin, Chen Yu, Zhao Hong-wei, Ma Hong, Li Chun-hua, Mi Kun, Liao Jian, Liu Kun, Liu Ji-feng, Zhu Gui-quan, Li Chao
From the *Department of Head and Neck Surgery; †Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu; ‡State Key Laboratory of Oral Diseases in Sichuan University, Sichuan; and §Department of Oral and Maxillary Surgery, The Affiliated Hospital of Guiyang Medical College, Guiyang, China.
J Craniofac Surg. 2013 Sep;24(5):1526-9. doi: 10.1097/SCS.0b013e31828dcdb3.
To study the effectiveness and safety of acellular dermal matrix (ADM) graft in preventing Frey syndrome after parotid neoplasm surgery, we reviewed foreign reported clinical randomized controlled trials systematically. Based on this review, we aimed to assess the effectiveness of ADM graft and provide reliable evidence for clinical application.
We reviewed foreign-language databases, such as MEDLINE, applied meta-analysis with Rev.Man 5, and drew forest plots with odds ratio as effect size.
Three trials were recruited. The morbidity of Frey syndrome in experimental group was significantly lower than that in control on both subjective index and objective index, with odds ratios at 0.03 (95% confidence interval, 0.01-0.11) and 0.03 (95% confidence interval, 0.01-0.12), respectively. There was no significant difference between ADM group and blank control in total adverse reactions and complication incidence, whereas results differed for a kind of specific adverse reaction or complication.
Based on existing research data, implanting ADM could effectively prevent Frey syndrome, and its poor prognosis effects did not significantly increase, which suggested that its total safety was reliable. Nevertheless, further investigations about the difference on a specific adverse reaction or complication were still needed.
为研究脱细胞真皮基质(ADM)移植在腮腺肿瘤手术后预防味觉出汗综合征中的有效性及安全性,我们系统回顾了国外报道的临床随机对照试验。基于该综述,我们旨在评估ADM移植的有效性,并为临床应用提供可靠依据。
我们检索了MEDLINE等外文数据库,使用Rev.Man 5进行荟萃分析,并绘制以比值比为效应量的森林图。
共纳入三项试验。在主观指标和客观指标上,试验组味觉出汗综合征的发病率均显著低于对照组,比值比分别为0.03(95%置信区间,0.01 - 0.11)和0.03(95%置信区间,0.01 - 0.12)。ADM组与空白对照组在总不良反应及并发症发生率方面无显著差异,但在某种特定不良反应或并发症方面结果有所不同。
基于现有研究数据,植入ADM可有效预防味觉出汗综合征,且其不良预后效应未显著增加,这表明其总体安全性可靠。然而,仍需进一步研究特定不良反应或并发症方面的差异。